Healthcare Provider Details

I. General information

NPI: 1922077858
Provider Name (Legal Business Name): SWEETWATER COUNTY COMMUNITY NURSING SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

731 C ST SUITE 315
ROCK SPRINGS WY
82901-6202
US

IV. Provider business mailing address

731 C ST SUITE 315
ROCK SPRINGS WY
82901-6202
US

V. Phone/Fax

Practice location:
  • Phone: 307-352-6830
  • Fax: 307-352-6844
Mailing address:
  • Phone: 307-352-6830
  • Fax: 307-352-6844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number06-071
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number06-071
License Number StateWY
# 3
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number06-071
License Number StateWY
# 4
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number07-008
License Number StateWY

VIII. Authorized Official

Name: JODYE WILMES
Title or Position: NURSING MANAGER
Credential: RN
Phone: 307-352-6830