Healthcare Provider Details

I. General information

NPI: 1043328719
Provider Name (Legal Business Name): COUNTY OF UINTA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 12/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 CITY VIEW DR STE 101
EVANSTON WY
82930-5327
US

IV. Provider business mailing address

225 9TH ST
EVANSTON WY
82930-3415
US

V. Phone/Fax

Practice location:
  • Phone: 307-789-9203
  • Fax: 307-789-6635
Mailing address:
  • Phone: 307-783-0300
  • Fax: 307-789-6635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number690830022
License Number StateWY

VIII. Authorized Official

Name: PATRICIA ARNOLD
Title or Position: NURSE MANAGER
Credential: RN
Phone: 307-789-9203