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General NPI Number Information
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NPI Number | 1427091347
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Entity Type | Organization
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Legal Business Name | NIOBRARA COUNTY HOSPITAL DISTRICT
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 02/08/2021
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Provider Practice Location Address
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Address Line | 921 S BALLANCEE AVENUE
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City | LUSK
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State | WY
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Zip | 82225
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Country | US
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Telephone | 307-334-4000
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Fax | 307-334-2712
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Provider Business Mailing Address
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Address Line | PO BOX 780
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City | LUSK
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State | WY
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Zip | 82225-0780
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Country | US
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Telephone | 307-334-4000
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Fax | 307-334-0183
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MS. NICHOLAS RYAN DOUCETTE
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Credential |
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Telephone | 307-334-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 06-203
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License Number State | WY
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