Healthcare Provider Details

I. General information

NPI: 1922919190
Provider Name (Legal Business Name): RICHELLE CYNTHIA WITT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1898 FORT RD
SHERIDAN WY
82801-8320
US

IV. Provider business mailing address

951 COVEY RUN RD APT 204
SHERIDAN WY
82801-3350
US

V. Phone/Fax

Practice location:
  • Phone: 307-672-3473
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6981024
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: