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General NPI Number Information
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NPI Number | 1770492282
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Entity Type | Individual
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Provider Name | KELSEY PERSIAN
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Gender | Female
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Dates
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Enumeration Date | 09/02/2026
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Last Update Date | 09/02/2026
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Provider Practice Location Address
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Address Line | 469 HIGHWAY 50
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City | GILLETTE
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State | WY
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Zip | 82718-9330
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Country | US
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Telephone | 307-682-1204
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Fax |
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Provider Business Mailing Address
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Address Line | 6800 FORCE RD
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City | GILLETTE
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State | WY
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Zip | 82718-4101
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Country | US
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Telephone | 307-299-5593
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 59347
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License Number State | WY
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