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General NPI Number Information
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NPI Number | 1154858736
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Entity Type | Organization
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Legal Business Name | HEALTH MEDICAL INSITITUTE
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Dates
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Enumeration Date | 05/15/2017
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 1401 AIRPORT PKWY STE 100
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City | CHEYENNE
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State | WY
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Zip | 82001-1522
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Country | US
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Telephone | 307-514-0510
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Fax | 307-514-0231
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Provider Business Mailing Address
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Address Line | 920 CREIGHTON ST
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City | CHEYENNE
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State | WY
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Zip | 82009-3229
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Country | US
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Telephone | 307-514-0510
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Fax | 307-514-0231
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | KRISTINE MARIE MARTINO
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Credential | FNP-C
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Telephone | 307-514-0510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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