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General NPI Number Information
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NPI Number | 1588708762
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Entity Type | Individual
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Provider Name | CARA R PEDRI
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Gender | Female
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Dates
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Enumeration Date | 02/19/2007
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Last Update Date | 01/24/2013
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Provider Practice Location Address
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Address Line | 1605 DONALYNN DR LOT 47
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City | ROCK SPRINGS
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State | WY
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Zip | 82901-7442
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Country | US
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Telephone | 307-922-1596
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 104
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City | ROCK SPRINGS
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State | WY
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Zip | 82902-0104
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Country | US
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Telephone | 307-922-1596
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 123014000
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License Number State | WY
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