Provider Demographics
NPI:1609363118
Name:INTEGRAL HEALTHCARE, LLC
Entity Type:Organization
Organization Name:INTEGRAL HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRATICTIONER
Authorized Official - Phone:307-760-5167
Mailing Address - Street 1:135 STEVENSON RD
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82070-6894
Mailing Address - Country:US
Mailing Address - Phone:307-760-5167
Mailing Address - Fax:970-232-9367
Practice Address - Street 1:502 S 4TH ST
Practice Address - Street 2:
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82070-3704
Practice Address - Country:US
Practice Address - Phone:307-755-1000
Practice Address - Fax:307-742-9717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-19
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty