MEDICARE: YVETTE DWYER

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	183500000X	Pharmacist	3012	WY

General Provider Information

NPI Number	:	1366822249
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YVETTE DWYER

Provider Business Mailing Address
First Line	:	4395 COLE CREEK
Second Line	:
City	:	EVANSVILLE
State	:	WY
Zip	:	82636-4224
Country	:	US
Telephone Number	:	307-797-0611
Fax Number	:

Provider Business Practice Location Address
First Line	:	1071 CY AVE
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-4224
Country	:	US
Telephone Number	:	307-234-9184
Fax Number	:

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

Provider Enumeration Date	:	06/04/2015
Last Update Date	:	01/31/2021

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Directions to “ YVETTE DWYER ” Practice Location

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