MEDICARE: JADEN ROCHELLE BINGHAM APRN, FNP-BC

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	363LF0000X	Family Nurse Practitioner	47073	WY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982293197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JADEN ROCHELLE BINGHAM APRN, FNP-BC

Provider Business Mailing Address
First Line	:	333 BROADWAY ST STE 120
Second Line	:
City	:	ROCK SPRINGS
State	:	WY
Zip	:	82901-6254
Country	:	US
Telephone Number	:	307-362-6813
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 BROADWAY ST STE 120
Second Line	:
City	:	ROCK SPRINGS
State	:	WY
Zip	:	82901-6254
Country	:	US
Telephone Number	:	307-362-6813
Fax Number	:	307-362-6891

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

Provider Enumeration Date	:	01/12/2021
Last Update Date	:	02/27/2025

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