Healthcare Provider Details

I. General information

NPI: 1487615837
Provider Name (Legal Business Name): NANCY JEAN HALSEY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2710 HARNEY ST STE 202
LARAMIE WY
82072-2899
US

IV. Provider business mailing address

1909 VISTA DR
LARAMIE WY
82070
US

V. Phone/Fax

Practice location:
  • Phone: 307-766-3316
  • Fax: 307-766-3316
Mailing address:
  • Phone: 307-745-8851
  • Fax: 307-742-0961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number199030376
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: