Healthcare Provider Details

I. General information

NPI: 1609023878
Provider Name (Legal Business Name): QUALITY OF LIFE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2008
Last Update Date: 08/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 BIRCH ST.
GLENROCK WY
82637
US

IV. Provider business mailing address

PO BOX 4393 1830 MARIPOSA BLVD.
CASPER WY
82604-0393
US

V. Phone/Fax

Practice location:
  • Phone: 307-251-2957
  • Fax: 307-333-1054
Mailing address:
  • Phone: 307-251-2957
  • Fax: 307-333-1054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number23786.0844
License Number StateWY

VIII. Authorized Official

Name: KAREN GRAVES-POSEY
Title or Position: PSYCHIATRIC NURSE PRACTITIONER
Credential: APRN, BC
Phone: 307-251-2957