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NPI Code Detail

MEDICARE: STEPHANIE HANWAY

MEDICARE: STEPHANIE 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
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1770912826
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE HANWAY
Provider Business Mailing Address
First Line : PO BOX 520
Second Line :
City : LARAMIE
State : WY
Zip : 82073-0520
Country : US
Telephone Number : 307-745-8997
Fax Number : 307-742-6146
Provider Business Practice Location Address
First Line : 4989 N 3RD ST
Second Line :
City : LARAMIE
State : WY
Zip : 82072-9548
Country : US
Telephone Number : 307-745-8997
Fax Number : 307-742-6146
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2013
Last Update Date : 11/08/2013

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Directions to “ STEPHANIE HANWAY ” Practice Location

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