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General NPI Number Information
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NPI Number | 1487280418
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Entity Type | Organization
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Legal Business Name | NATURALLY BEAUTIFUL YOU
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Dates
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Enumeration Date | 03/21/2020
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Last Update Date | 03/21/2020
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Provider Practice Location Address
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Address Line | 4510 E 22ND ST
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City | CASPER
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State | WY
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Zip | 82609-4659
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Country | US
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Telephone | 307-359-2900
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Fax | 307-234-6708
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Provider Business Mailing Address
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Address Line | 4510 E 22ND ST
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City | CASPER
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State | WY
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Zip | 82609-4659
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Country | US
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Telephone | 307-359-2900
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Fax | 307-234-6708
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Authorized Official
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Title or Position | NP
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Name | MS. JACQUELINE RETHERFORD
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Credential | APRN
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Telephone | 307-359-2900
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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 |
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License Number State |
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