Provider Demographics
NPI:1306609003
Name:CRITICAL PERINATAL SOLUTIONS P.C.
Entity type:Organization
Organization Name:CRITICAL PERINATAL SOLUTIONS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:POULIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:307-205-3084
Mailing Address - Street 1:514 E GRAND AVE # 320
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82070-3839
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:810 SALLY PORT RD
Practice Address - Street 2:
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82070-8327
Practice Address - Country:US
Practice Address - Phone:307-205-3084
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-05
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Multi-Specialty