Healthcare Provider Details

I. General information

NPI: 1083528277
Provider Name (Legal Business Name): HANNAH STUART-WALKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 W POWELL RD
CHEYENNE WY
82009-1612
US

IV. Provider business mailing address

111 W POWELL RD
CHEYENNE WY
82009-1612
US

V. Phone/Fax

Practice location:
  • Phone: 307-920-1604
  • Fax:
Mailing address:
  • Phone: 307-920-1604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: