Organization · NPI-2

Alpha Family Medicine, INC.

Family Medicine · Cheyenne, WY

NPI number1215944301
StatusActive
Last updated in NPPESSep 10, 2007

Details

NPI
1215944301
Entity type
Organization (NPI-2)
Legal business name
Alpha Family Medicine, INC.
Organization subpart
No
Enumeration date
Aug 2, 2006
Last updated
Sep 10, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine5374AWYYes
363LF0000X Nurse Practitioner, Family––

Practice location

1202 Cleveland Ave
Cheyenne, WY 82001-6700

Phone 307-632-6403 · Fax 307-632-6426

Mailing address

1202 Cleveland Ave
Cheyenne, WY 82001-6700

Phone 307-632-6403 · Fax 307-632-6426

Authorized official

Kathleen M Gates
Owner
3076326403

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