Provider Demographics
NPI:1275632275
Name:COUNTY OF WASHAKIE
Entity Type:Organization
Organization Name:COUNTY OF WASHAKIE
Other - Org Name:WASHAKIE COUNTY PUBLIC HEALTH/FAMILY PLANNING
Other - Org Type:Other Name
Authorized Official - Title/Position:NURSE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HEINEMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:307-347-3278
Mailing Address - Street 1:1007 ROBERTSON AVE.
Mailing Address - Street 2:
Mailing Address - City:WORLAND
Mailing Address - State:WY
Mailing Address - Zip Code:82401-2720
Mailing Address - Country:US
Mailing Address - Phone:307-347-3278
Mailing Address - Fax:307-347-3270
Practice Address - Street 1:1007 ROBERTSON AVE
Practice Address - Street 2:
Practice Address - City:WORLAND
Practice Address - State:WY
Practice Address - Zip Code:82401-2720
Practice Address - Country:US
Practice Address - Phone:307-347-3278
Practice Address - Fax:307-347-3270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2023-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY107313300Medicaid