Healthcare Provider Details

I. General information

NPI: 1649567710
Provider Name (Legal Business Name): OPSAL NURSING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2011
Last Update Date: 07/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1906 HARVEST MOON DR
GILLETTE WY
82718-7878
US

IV. Provider business mailing address

1906 HARVEST MOON DR
GILLETTE WY
82718-7878
US

V. Phone/Fax

Practice location:
  • Phone: 307-696-7684
  • Fax:
Mailing address:
  • Phone: 307-696-7684
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number27525
License Number StateWY

VIII. Authorized Official

Name: MRS. BRITNEE LEE OPSAL
Title or Position: OWNER/RN
Credential: RN
Phone: 307-696-7684