Healthcare Provider Details

I. General information

NPI: 1134072283
Provider Name (Legal Business Name): THOMAS CAIN FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3435 N COLLEGE DR STE A
CHEYENNE WY
82001-2088
US

IV. Provider business mailing address

4539 MOCCASIN CIR
LAPORTE CO
80535-9536
US

V. Phone/Fax

Practice location:
  • Phone: 307-456-1919
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.1001581-NP
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number58670
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: