Provider Demographics
NPI:1609023878
Name:QUALITY OF LIFE, P.C.
Entity Type:Organization
Organization Name:QUALITY OF LIFE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAVES-POSEY
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, BC
Authorized Official - Phone:307-251-2957
Mailing Address - Street 1:PO BOX 4393
Mailing Address - Street 2:1830 MARIPOSA BLVD.
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82604-0393
Mailing Address - Country:US
Mailing Address - Phone:307-251-2957
Mailing Address - Fax:307-333-1054
Practice Address - Street 1:506 BIRCH ST.
Practice Address - Street 2:
Practice Address - City:GLENROCK
Practice Address - State:WY
Practice Address - Zip Code:82637
Practice Address - Country:US
Practice Address - Phone:307-251-2957
Practice Address - Fax:307-333-1054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY23786.0844363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY1336237833OtherNPPES