Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 47162 | WY |
NPI | 1104418789 |
---|---|
Provider Name | Kathleen Parmer |
First Address | Cheyenne, WY 82001-1774 |
Second Address | Cheyenne, WY 82001-3783 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2021 |
Last Update Date | 05/02/2021 |