Healthcare Provider Details

I. General information

NPI: 1437088226
Provider Name (Legal Business Name): CHANEL MARIE THRASHER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 ELM ST
RAWLINS WY
82301-5108
US

IV. Provider business mailing address

PO BOX 475
SARATOGA WY
82331-0475
US

V. Phone/Fax

Practice location:
  • Phone: 307-324-2221
  • Fax:
Mailing address:
  • Phone: 325-315-3455
  • Fax: 325-315-3455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53107
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: