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General NPI Number Information
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NPI Number | 1184587925
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Entity Type | Individual
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Provider Name | ALYSSA JO WHITLOCK
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Gender | Female
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 424 YELLOWSTONE AVE STE 330
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City | CODY
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State | WY
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Zip | 82414-8917
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Country | US
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Telephone | 307-578-2770
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Fax |
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Provider Business Mailing Address
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Address Line | 707 SHERIDAN AVE
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City | CODY
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State | WY
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Zip | 82414-3409
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Country | US
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Telephone | 307-527-7501
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Fax | 307-578-2485
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 43660
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 43660
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License Number State | WY
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Taxonomy #3
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 43660
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License Number State | WY
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