Healthcare Provider Details

I. General information

NPI: 1386407963
Provider Name (Legal Business Name): 307 HOPE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1208 HILLTOP DR STE 104
ROCK SPRINGS WY
82901-5858
US

IV. Provider business mailing address

1208 HILLTOP DR STE 104
ROCK SPRINGS WY
82901-5858
US

V. Phone/Fax

Practice location:
  • Phone: 307-371-2427
  • Fax: 307-224-2128
Mailing address:
  • Phone: 307-371-2427
  • Fax: 858-947-2019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. TAMARA SUE WALKER
Title or Position: MEDICAL DIRECTOR/OWNER
Credential: PMHNP, PNP, PMHS
Phone: 307-679-1286