DR. SKY WOLF (NPI# 1174765093) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174765093 |
| Entity Type | Individual |
| Full Name | DR. SKY WOLF |
| Practice Address |
6900 Alden Dr Bldg 160 Cheyenne WY 82005-3906 |
| Practice Telephone | 3077732779 |
| Mailing Telephone | 3077732779 |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2020-01-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 12285A | WY | Allopathic & Osteopathic Physicians |
| N | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
20A11115 | CA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care | ||
| Y | 171000000X | Military Health Care Provider | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 820 E 17th St, Cheyenne, WY 820014714 | 3076322434 | |
| 9500 Gilman Dr, La Jolla, CA 920930811 | 8585349540 | 8585349404 |
| Street Address |
6900 ALDEN DR BLDG 160 |
| City | CHEYENNE |
| State | WY |
| Zip Code | 82005-3906 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285250597 | Brittany Corrin Souder | Military Health Care Provider | 1600 Aldene Drive, Fe Warren Afb, WY 82005 | 2020-06-23 |
| 1093368110 | Aaron Michael Keating | Student in an Organized Health Care Education/Training Program | Mental Health Clinic, 90th Omrs, Fe Warren Clinic, Fe Warren Afb, WY 82005 | 2019-07-17 |
| 1477643823 | Paul Hoon Kim | Dentist | 90 Mdos, 6900 Alden Dr, F.e. Warren Afb, WY 82005 | 2006-10-14 |
| 1568495315 | Joseph Myles Simpson, Jr. | Dentist | F E Warren Air Force Base Dental Clinic, 6900 Alden Drive, Cheyenne, WY 82005 | 2006-07-07 |
| 1679953640 | Mary Frances Macleod | Pediatrics | 6900 Alden Dr, Fe Warren Afb, WY 82005 | 2015-06-04 |
| 1306864632 | Lisa Sung Eun Lee | Pharmacist | 6900 Alden Drive, Fe Warren Afb, WY 82005 | 2006-07-17 |
| 1225097371 | George Miller Hilgendorf Jr. | Dentist | 6900 Alden Dr, 90 Mdg, Fe Warren Afb, WY 82005 | 2006-03-18 |
| 1194716159 | Steven L Martin | Physician Assistant | 6900 Alden Dr, Cheyenne, WY 82005 | 2005-10-31 |
| 1992957252 | Perala Enterprises, LLC | Eyewear Supplier (Equipment, not the service) | 6207 Missile Dr, Building 722, Ft Warren Afb, WY 82005-2407 | 2008-10-17 |
| 1548814890 | Jonathan R Courtright | Physician Assistant | 6900 Alden Dr, Cheyenne, WY 82005-2945 | 2019-07-25 |
| Find all providers in zip 82005 | ||||
| Taxonomy Code | 171000000X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
| Notes: [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992108559 | Lisa Day | Military Health Care Provider | 303 S Main St, Suite 105, Sheridan, WY 82801-4876 | 2014-09-26 |
Please comment or provide details below to improve the information on DR. SKY WOLF.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.