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General NPI Number Information
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NPI Number | 1265497184
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Entity Type | Individual
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Provider Name | LINDA ARLENE THYFAULT APN
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Gender | Female
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Dates
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Enumeration Date | 04/20/2006
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Last Update Date | 07/29/2011
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Provider Practice Location Address
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Address Line | 100 CENTRAL AVE
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City | CHEYENNE
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State | WY
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Zip | 82007-1330
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Country | US
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Telephone | 307-633-4043
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Fax |
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Provider Business Mailing Address
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Address Line | 100 CENTRAL AVE
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City | CHEYENNE
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State | WY
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Zip | 82007-1330
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Country | US
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Telephone | 307-633-4043
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Fax |
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 10132.68
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License Number State | WY
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