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General NPI Number Information
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NPI Number | 1881242816
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Entity Type | Individual
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Provider Name | JULIANNE E FORRESTER FNP
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Gender | Female
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Dates
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Enumeration Date | 09/03/2019
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Last Update Date | 09/16/2019
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Provider Practice Location Address
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Address Line | 1400 UINTA DR
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City | GREEN RIVER
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State | WY
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Zip | 82935-5060
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Country | US
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Telephone | 307-872-4500
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Fax | 307-872-4595
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Provider Business Mailing Address
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Address Line | PO BOX 219
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City | GREEN RIVER
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State | WY
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Zip | 82935-0219
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Country | US
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Telephone | 307-872-4500
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Fax | 307-872-4595
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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 | 44631
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 34154
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License Number State | WY
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