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General NPI Number Information
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NPI Number | 1851197610
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Entity Type | Organization
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Legal Business Name | SNOW DAY PSYCHIATRY LLC
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Dates
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Enumeration Date | 02/21/2025
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 1621 CENTRAL AVE STE 8211
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City | CHEYENNE
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State | WY
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Zip | 82001-4531
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Country | US
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Telephone | 73-872-0013
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Fax | 307-387-2004
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Provider Business Mailing Address
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Address Line | 1621 CENTRAL AVE # 8211
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City | CHEYENNE
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State | WY
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Zip | 82001-4531
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Country | US
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Telephone | 73-872-0013
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Fax | 307-387-2004
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MARK LANDON MILLWOOD JR.
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Credential | APRN
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Telephone | 901-496-8884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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