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General NPI Number Information
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NPI Number | 1942710447
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Entity Type | Individual
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Provider Name | CRISTY LEANN HALL-EDERER DNP
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Gender | Female
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Dates
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Enumeration Date | 10/10/2017
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Last Update Date | 02/11/2019
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Provider Practice Location Address
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Address Line | 5890 E 2ND ST
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City | CASPER
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State | WY
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Zip | 82609-4308
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Country | US
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Telephone | 307-337-4058
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Fax |
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Provider Business Mailing Address
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Address Line | 2474 ROAD 218
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City | CHEYENNE
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State | WY
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Zip | 82009-9149
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Country | US
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Telephone | 405-888-9992
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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 | APN.0993097-NP
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License Number State | CO
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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 | 40548-1655
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License Number State | WY
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5010868
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License Number State | NC
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