Provider Demographics
NPI:1558835413
Name:STRATTON, JOSEPHINE KENNON (RN)
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:KENNON
Last Name:STRATTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JOSEPHINE
Other - Middle Name:KENNON
Other - Last Name:RUSSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:231 SOUTH WILSON STREET
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-2941
Mailing Address - Country:US
Mailing Address - Phone:307-265-3791
Mailing Address - Fax:307-265-4460
Practice Address - Street 1:606 23RD STREET
Practice Address - Street 2:
Practice Address - City:RAWLINS
Practice Address - State:WY
Practice Address - Zip Code:82301-5127
Practice Address - Country:US
Practice Address - Phone:307-327-8820
Practice Address - Fax:307-333-0261
Is Sole Proprietor?:No
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY34120163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse