DR. WILSON FULLA BERNALES (NPI# 1508824467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508824467 |
| Entity Type | Individual |
| Full Name | DR. WILSON FULLA BERNALES |
| Credential | M.D. |
| Practice Address |
428 S Durbin St Suite 104 Casper WY 82601-2818 |
| Mailing Address |
428 S Durbin St Ste 104 Casper WY 82601-2818 |
| Practice Telephone | 3073374284 |
| Practice Fax Number | 3074620922 |
| Mailing Telephone | 3073374284 |
| Mailing Fax Number | 3074620922 |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2016-12-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 7632A | WY | Allopathic & Osteopathic Physicians |
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
C1-0007844 | DE | Allopathic & Osteopathic Physicians |
| Street Address |
428 S DURBIN ST SUITE 104 |
| City | CASPER |
| State | WY |
| Zip Code | 82601-2818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962499491 | Casper Payless Drug | Durable Medical Equipment & Medical Supplies | 428 S Durbin St, Casper, WY 82601-2818 | 2005-09-30 |
| 1447869474 | Poudre Valley Medical Group, LLC | Internal Medicine | 428 S Durbin St, Casper, WY 82601-2820 | 2020-07-27 |
| 1306196209 | Cedars Health | Clinic/Center | 428 S Durbin St, Casper, WY 82601-2818 | 2012-09-18 |
| 1003066838 | Jason Dee Lovell | Internal Medicine | 428 S Durbin St, Ste 104, Casper, WY 82601-2818 | 2008-09-29 |
| 1003961434 | Molly H. Peak | Pharmacy Technician | 428 S Durbin St, Casper, WY 82601-2818 | 2007-01-24 |
| 1689600892 | Lanae Deann Pickard | Occupational Therapist | 428 S Durbin St, Ste 104, Casper, WY 82601-2829 | 2006-06-23 |
| 1427026277 | Patricia A Bell | Obstetrics & Gynecology | 428 S Durbin St, Ste 104, Casper, WY 82601-2818 | 2006-03-09 |
| 1093703456 | Jody J. Alvies | Pharmacy Technician | 428 S Durbin St, Casper, WY 82601-2818 | 2005-10-10 |
| 1457349813 | Bella J. Tipton | Pharmacy Technician | 428 S Durbin St, Casper, WY 82601-2818 | 2005-10-10 |
| 1699762492 | Iris C. Harnagel | Pharmacist | 428 S Durbin St, Casper, WY 82601-2818 | 2005-10-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407472715 | Kira Christine Schaab | Student in an Organized Health Care Education/Training Program | University of Wyoming Fmrp - Casper 1522 East A Street, Casper, WY 82601 | 2020-06-23 |
| 1386111300 | Kyle David Gordon | Pharmacist | 2625 E. 2nd St., Pharmacy, Casper, WY 82601 | 2018-10-29 |
| 1225534050 | Stephanie Wendling | Social Worker | 143 S Summit St., Casper, WY 82601 | 2018-04-02 |
| 1457877987 | Deer Creek Dentistry, PC | Dentist | 514 South Durbin Street, Casper, WY 82601 | 2017-08-16 |
| 1679096382 | Rachael Kristin Clark | Case Management | 2317 Absaroka Trail, Bar Nunn, WY 82601 | 2017-07-25 |
| 1366998692 | Trenton Vonburg | Occupational Therapy Assistant | 2744 Fairdale Ave, Casper, WY 82601 | 2016-08-28 |
| 1619326618 | Traci L Aguilar | Massage Therapist | 221 S. Walcott, Casper, WY 82601 | 2016-06-09 |
| 1801256656 | Anita Walker | Speech-Language Pathologist | 851 Werner Ct., Ste. 100, Sensational Kids, Casper, WY 82601 | 2016-03-07 |
| 1528444304 | Jack Miller | Pharmacist | 1262 S. Conwell Stc, Casper, WY 82601 | 2015-08-04 |
| 1437556453 | Kelly Jo Plessman | Nurse Practitioner | 2521 East 15th Street, Casper, WY 82601 | 2014-11-20 |
| Find all providers in zip 82601 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649573221 | Burke & Burke, Md, PC | Family Medicine | 940 E 3rd St, Suite # 202, Casper, WY 82601-3237 | 2010-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023078128 | Robert D. Langer | Family Medicine | 555 E. Broadway, Suite 108, Jackson, WY 83001 | 2006-03-24 |
| 1003078148 | Kristine K Van Kirk | Family Medicine | 6015 Sycamore Rd, Cheyenne, WY 82009-4347 | 2008-06-30 |
| 1699838862 | Howard T Willson | Family Medicine | 388 South Us Hwy 20, Basin, WY 82410-8902 | 2006-12-19 |
| 1346336500 | Joanie Marie Deatrich | Family Medicine | 2360 E Pershing Blvd, Cheyenne, WY 82001-5356 | 2006-10-05 |
| 1467417535 | Milford Eugene Thieszen | Family Medicine | 2360 E Pershing Blvd, Cheyenne, WY 82001-5356 | 2006-04-19 |
Please comment or provide details below to improve the information on DR. WILSON FULLA BERNALES.
| 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.