Provider Demographics
NPI:1407804081
Name:SIEGEL, MARSHA KAYE (EDD, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:MARSHA
Middle Name:KAYE
Last Name:SIEGEL
Suffix:
Gender:F
Credentials:EDD, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2345 E RIDING CLUB RD
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-9707
Mailing Address - Country:US
Mailing Address - Phone:307-634-9285
Mailing Address - Fax:
Practice Address - Street 1:4140 LARAMIE ST
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-1969
Practice Address - Country:US
Practice Address - Phone:307-637-2800
Practice Address - Fax:307-637-2867
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY11380.0089363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY308576OtherBCBS
WYP00025709OtherRRMDC
WY115910101Medicaid
WYP00025709OtherRRMDC
WY308576Medicare ID - Type Unspecified