Healthcare Provider Details

I. General information

NPI: 1811087364
Provider Name (Legal Business Name): CROOK COUNTY PUBLIC HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 1/2 E. MAIN STREET
SUNDANCE WY
82729-0543
US

IV. Provider business mailing address

420 1/2 E. MAIN STREET P.O. BOX 543
SUNDANCE WY
82729-0543
US

V. Phone/Fax

Practice location:
  • Phone: 307-283-1142
  • Fax: 307-283-1143
Mailing address:
  • Phone: 307-283-1142
  • Fax: 307-283-1143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: REBECCA TINSLEY
Title or Position: NURSE MANAGER
Credential: RN
Phone: 307-283-1142