Provider Demographics
NPI:1063390656
Name:HIGH POINT WELLNESS, LLC
Entity type:Organization
Organization Name:HIGH POINT WELLNESS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:PEDIATRIC NP
Authorized Official - Phone:307-212-6082
Mailing Address - Street 1:1208 HILLTOP DR STE 103
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-5858
Mailing Address - Country:US
Mailing Address - Phone:307-212-6082
Mailing Address - Fax:307-224-2128
Practice Address - Street 1:1208 HILLTOP DR STE 103
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-5858
Practice Address - Country:US
Practice Address - Phone:307-212-6082
Practice Address - Fax:307-224-2128
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HIGH POINT WELLNESS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-08-22
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY1730730771OtherPEDIATRIC NURSE PRACTICIONER