Provider Demographics
NPI:1225343031
Name:BORCHER, JESSI R
Entity Type:Individual
Prefix:
First Name:JESSI
Middle Name:R
Last Name:BORCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 GREENFIELD DR
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:WY
Mailing Address - Zip Code:82435-2249
Mailing Address - Country:US
Mailing Address - Phone:307-754-3462
Mailing Address - Fax:307-271-7839
Practice Address - Street 1:1004 GREENFIELD DR
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:WY
Practice Address - Zip Code:82435-2249
Practice Address - Country:US
Practice Address - Phone:307-754-3462
Practice Address - Fax:307-271-7839
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-17
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator