Provider Demographics
NPI:1811087364
Name:CROOK COUNTY PUBLIC HEALTH
Entity type:Organization
Organization Name:CROOK COUNTY PUBLIC HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NURSE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:TINSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:307-283-1142
Mailing Address - Street 1:420 1/2 E. MAIN STREET
Mailing Address - Street 2:P.O. BOX 543
Mailing Address - City:SUNDANCE
Mailing Address - State:WY
Mailing Address - Zip Code:82729-0543
Mailing Address - Country:US
Mailing Address - Phone:307-283-1142
Mailing Address - Fax:307-283-1143
Practice Address - Street 1:420 1/2 E. MAIN STREET
Practice Address - Street 2:
Practice Address - City:SUNDANCE
Practice Address - State:WY
Practice Address - Zip Code:82729-0543
Practice Address - Country:US
Practice Address - Phone:307-283-1142
Practice Address - Fax:307-283-1143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QF0050X
WY251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY107240400Medicaid
WY107240400Medicaid