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General NPI Number Information
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NPI Number | 1639701899
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Entity Type | Organization
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Legal Business Name | A BEAUTIFUL MIND LLC
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Dates
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Enumeration Date | 02/06/2020
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 145 S DURBIN ST STE 301
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City | CASPER
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State | WY
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Zip | 82601-2567
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Country | US
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Telephone | 307-337-1173
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Fax | 307-337-1221
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Provider Business Mailing Address
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Address Line | 145 S DURBIN ST STE 207
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City | CASPER
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State | WY
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Zip | 82601-2566
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Country | US
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Telephone | 307-337-1173
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Fax | 307-337-1221
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | DR. MICHELLE LEE HIPSAK
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Credential | DNP, APRN, PMHNP-BC
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Telephone | 307-337-1173
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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