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NPI Code Detail

MEDICARE: MRS. CHELSEA PUENTE PA-C

MEDICARE: MRS. CHELSEA PUENTE PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant583WY

General Provider Information

NPI Number : 1083044630
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHELSEA PUENTE PA-C
Provider Business Mailing Address
First Line : 497 W LOTT ST
Second Line :
City : BUFFALO
State : WY
Zip : 82834-1658
Country : US
Telephone Number : 307-684-5521
Fax Number : 307-684-5385
Provider Business Practice Location Address
First Line : 497 W LOTT ST
Second Line :
City : BUFFALO
State : WY
Zip : 82834-1658
Country : US
Telephone Number : 307-684-5521
Fax Number : 307-684-5385
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2013
Last Update Date : 11/18/2013

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Directions to “ MRS. CHELSEA PUENTE PA-C” Practice Location

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