Provider Demographics
NPI:1114735586
Name:WOMENS WELLNESS OF WYOMING LLC
Entity type:Organization
Organization Name:WOMENS WELLNESS OF WYOMING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CASSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:AMADIO
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:307-267-9650
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:
Mailing Address - Fax:
Practice Address - Street 1:210 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2907
Practice Address - Country:US
Practice Address - Phone:307-267-9650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-18
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty