Provider Demographics
NPI:1992310999
Name:INTEGRATIVE HEALTH SPECIALISTS, LLC
Entity type:Organization
Organization Name:INTEGRATIVE HEALTH SPECIALISTS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOUISA
Authorized Official - Middle Name:
Authorized Official - Last Name:CROSBY
Authorized Official - Suffix:
Authorized Official - Credentials:AGACNP
Authorized Official - Phone:307-752-2928
Mailing Address - Street 1:23 E BRUNDAGE ST STE 1
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-6302
Mailing Address - Country:US
Mailing Address - Phone:307-752-9190
Mailing Address - Fax:
Practice Address - Street 1:23 E BRUNDAGE ST STE 1
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-6302
Practice Address - Country:US
Practice Address - Phone:307-952-9190
Practice Address - Fax:307-207-8847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-15
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty