Provider Demographics
NPI:1467033241
Name:MCCLANAHAN, NATALIE RUTH (FNP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:RUTH
Last Name:MCCLANAHAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 LONESOME FOX RD
Mailing Address - Street 2:
Mailing Address - City:MCFADDEN
Mailing Address - State:WY
Mailing Address - Zip Code:82083-9715
Mailing Address - Country:US
Mailing Address - Phone:307-399-6565
Mailing Address - Fax:
Practice Address - Street 1:214 E 23RD ST
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3748
Practice Address - Country:US
Practice Address - Phone:307-634-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-14
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY34563163WE0003X
WY47882363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency