Diva Bermudez
Case Manager/Care Coordinator in Evanston, WY. Individual provider (NPI-1).
NPI number1699290528
StatusActive
Last updated in NPPESJun 13, 2021
Details
- NPI
- 1699290528
- Entity type
- Individual (NPI-1)
- Name
- Diva Bermudez
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 11, 2017
- Certification date
- Jun 13, 2021
- Last updated
- Jun 13, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | – | – | Yes |
Practice location
1101 Center StEvanston, WY 82930-3383
Phone 307-789-0241
Mailing address
100 Harrison Dr Unit 1011Evanston, WY 82931-0658
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