Provider Demographics
NPI:1144982190
Name:PERRY, RAULI JO (WHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:RAULI
Middle Name:JO
Last Name:PERRY
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1333
Mailing Address - Street 2:
Mailing Address - City:PINEDALE
Mailing Address - State:WY
Mailing Address - Zip Code:82941-1333
Mailing Address - Country:US
Mailing Address - Phone:208-404-5228
Mailing Address - Fax:
Practice Address - Street 1:625 E HENNICK ST
Practice Address - Street 2:
Practice Address - City:PINEDALE
Practice Address - State:WY
Practice Address - Zip Code:82941-5228
Practice Address - Country:US
Practice Address - Phone:307-367-4133
Practice Address - Fax:307-367-6636
Is Sole Proprietor?:No
Enumeration Date:2021-10-07
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID53557363LW0102X
WY54282363LW0102X
MT215881363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health