Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 143511085 | WY |
NPI | 1023310984 |
---|---|
Provider Name | Mrs. Beth Janine Romsa |
First Address | Laramie, WY 82070-7335 |
Second Address | Laramie, WY 82072-2343 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2010 |
Last Update Date | 29/11/2010 |