Provider Demographics
NPI:1669750394
Name:HISER, VELVET MAUREEN (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:VELVET
Middle Name:MAUREEN
Last Name:HISER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 S FENWAY ST STE 202
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-3053
Mailing Address - Country:US
Mailing Address - Phone:307-577-7737
Mailing Address - Fax:307-577-0049
Practice Address - Street 1:301 S FENWAY ST STE 202
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-3053
Practice Address - Country:US
Practice Address - Phone:307-577-7737
Practice Address - Fax:307-577-0049
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY15557.1120363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily