Provider Demographics
NPI:1457064917
Name:MS HOLDINGS, LLC
Entity Type:Organization
Organization Name:MS HOLDINGS, LLC
Other - Org Name:EVOLVE HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISING PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:KATE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITAKER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-BC
Authorized Official - Phone:307-262-7044
Mailing Address - Street 1:PO BOX 2170
Mailing Address - Street 2:
Mailing Address - City:MILLS
Mailing Address - State:WY
Mailing Address - Zip Code:82644-2170
Mailing Address - Country:US
Mailing Address - Phone:307-262-7044
Mailing Address - Fax:
Practice Address - Street 1:6631 E 2ND ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-4355
Practice Address - Country:US
Practice Address - Phone:073-333-4713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-29
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service