MEDICARE: SHEREACE HANWAY

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
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1295540508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEREACE HANWAY

Provider Business Mailing Address
First Line	:	PO BOX 868
Second Line	:
City	:	RIVERTON
State	:	WY
Zip	:	82501-0116
Country	:	US
Telephone Number	:	307-463-4242
Fax Number	:

Provider Business Practice Location Address
First Line	:	902 N 8TH ST W
Second Line	:
City	:	RIVERTON
State	:	WY
Zip	:	82501-2332
Country	:	US
Telephone Number	:	307-463-4242
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2025
Last Update Date	:	02/12/2025

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Directions to “ SHEREACE HANWAY ” Practice Location

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