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General NPI Number Information
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NPI Number | 1619861671
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Entity Type | Organization
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Legal Business Name | CLOUD PEAK PEDIATRICS, LLC
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Dates
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Enumeration Date | 06/04/2025
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 530 RUNNING W DR # 120
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City | GILLETTE
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State | WY
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Zip | 82718-2074
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Country | US
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Telephone | 920-296-4306
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Fax |
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Provider Business Mailing Address
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Address Line | 6601 STONE VIEW CT
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City | GILLETTE
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State | WY
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Zip | 82718-6183
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Country | US
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Telephone | 307-687-7337
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT
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Name | VALERIE AMSTADT
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Credential | PA-C
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Telephone | 920-296-4306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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