Organization · NPI-2

Affinity Family Practice

Family Medicine · Cheyenne, WY

NPI number1255970034
StatusActive
Last updated in NPPESApr 30, 2020

Details

NPI
1255970034
Entity type
Organization (NPI-2)
Legal business name
Affinity Family Practice
Organization subpart
No
Enumeration date
Dec 27, 2019
Certification date
Apr 30, 2020
Last updated
Apr 30, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes

Practice location

903 S Greeley Hwy Ste A
Cheyenne, WY 82007-3057

Phone 307-514-1523 · Fax 307-514-1526

Mailing address

903 S Greeley Hwy Ste A
Cheyenne, WY 82007-3057

Phone 307-514-1523 · Fax 307-514-1526

Authorized official

Traci Lynn Buran
Owner And Provider
3075141523

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