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General NPI Number Information
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NPI Number | 1518279678
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Entity Type | Individual
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Provider Name | KIM WESTBROOK M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/06/2010
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Last Update Date | 07/30/2015
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Provider Practice Location Address
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Address Line | 2710 HARNEY ST SUITE 100
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City | LARAMIE
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State | WY
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Zip | 82072-3038
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Country | US
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Telephone | 307-745-8991
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Fax |
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Provider Business Mailing Address
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Address Line | 2710 HARNEY ST SUITE 100
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City | LARAMIE
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State | WY
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Zip | 82072-3038
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Country | US
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Telephone | 307-745-8991
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | TEP 6362
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License Number State | NE
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