POPO AGIE WOMEN'S CLINIC, INC (NPI# 1871623124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871623124 |
| Entity Type | Organization |
| Organization Name | POPO AGIE WOMEN'S CLINIC, INC |
| Other Organization Name | POPO AGIE WOMEN'S CLINIC |
| Practice Address |
1460 Main St Lander WY 82520-2657 |
| Practice Telephone | 3073322223 |
| Mailing Telephone | 3073322223 |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2009-03-05 |
| Authorized Official Name | MRS. RUTH C ZEBROSKI (PRESIDENT) |
| Authorized Official Telephone | 3073322223 |
| Authorized Official Credential | WHNP-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
9192.0137 | WY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
9192.0137 | WY | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
9192.0137 | WY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 116652200 | 05 |
| Other Name | Type Code |
|---|---|
| Popo Agie Women's Clinic | Former Legal Business Name - Organization |
| Street Address |
1460 MAIN ST |
| City | LANDER |
| State | WY |
| Zip Code | 82520-2657 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487608048 | Karen Wendt | Advanced Practice Midwife | 1460 Main St, Lander, WY 82520-2657 | 2006-05-19 |
| 1114057080 | Jacques D. Beveridge Md, Inc. | Advanced Practice Midwife | 1460 Main St, Suite B, Lander, WY 82520-2657 | 2007-03-07 |
| 1457454837 | Thomas E Dunaway | Obstetrics & Gynecology | 1460 Main St, Lander, WY 82520-2657 | 2006-09-07 |
| 1467499244 | Patricia Declue | Nurse Practitioner | 1460 Main St, Lander, WY 82520-2657 | 2006-06-01 |
| 1902850464 | Ruth C Zebroski | Nurse Practitioner | 1460 Main St, Lander, WY 82520-2657 | 2006-05-20 |
| 1669426292 | Jacques D. Beveridge Md | Obstetrics & Gynecology | 1460 Main St, Suite B, Lander, WY 82520-2657 | 2006-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689288201 | Wind River Wraparound | Community/Behavioral Health | 16 Sandhills Rd., Lander, WY 82520 | 2020-09-01 |
| 1346700622 | Wind River Family & Community Health Care | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 510 Ethete Rd., Ethete, WY 82520 | 2019-03-22 |
| 1447710843 | Wind River Family and Community Health Care | Clinic/Center | 510 Ethete Road, Ethete, WY 82520 | 2019-03-21 |
| 1780103614 | John Thomas Scarince | Case Manager/Care Coordinator | 748 Main, Lander, WY 82520 | 2017-09-12 |
| 1326560780 | Benessere Clinic LLC | Specialist | 195 Capitol St., Lander, WY 82520 | 2017-07-07 |
| 1881134500 | Susan Kreager | Nutritionist | 643 Blue Sky Hwy 132, Ethete, WY 82520 | 2017-02-28 |
| 1346792298 | Elisabeth Krause | Clinic/Center | 65 N, Granier Ave, Atlantic City, WY 82520 | 2016-10-26 |
| 1649640368 | Melinda Kay Cox | Day Training, Developmentally Disabled Services | 382 Washakie, Lander, WY 82520 | 2015-10-07 |
| 1942602677 | Carmen Champlin | Registered Nurse | 397 S 5th, Lander, WY 82520 | 2014-09-25 |
| 1366867806 | Kelly Johnson | Social Worker | 7324 Highway 789, Lander, WY 82520 | 2014-02-20 |
| Find all providers in zip 82520 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487931416 | Stephanie Lee Dupree | Nurse Practitioner | 1204 Hilltop Dr. #107 & #108, Rock Springs, WY 82901 | 2011-11-04 |
| 1558373340 | J'laine Proctor | Nurse Practitioner | 1465 N 4th St, Suite #119, Laramie, WY 82072-2066 | 2006-08-12 |
| 1801855606 | Deborah Elizabeth Mcalpine | Nurse Practitioner | 1898 Fort Road, Sheridan, WY 82801-2718 | 2006-03-21 |
| 1184601700 | Diane Kenton Mattern | Nurse Practitioner | 475 South Spruce, Casper Natrona County Health Department, Casper, WY 82601-0000 | 2005-12-23 |
| 1043683691 | Patricia Mcjilton | Nurse Practitioner | 501 S Burma Ave, Gillette, WY 82716-3426 | 2015-11-04 |
| 1790182368 | Kelly Spychalski | Nurse Practitioner | 1025 9th St, Cody, WY 82414 | 2014-11-26 |
| 1215370754 | Celia Elizabeth Rife | Nurse Practitioner | 214 E 23rd St, Cheyenne, WY 82001-3748 | 2013-04-15 |
| 1538310925 | Ann Marie Hart, Fnp, PC | Nurse Practitioner | 255 N 30th St, Ivinson Memorial Hospital, Suite 5b Specialty Clinic, Laramie, WY 82072-5140 | 2008-10-04 |
| 1114149655 | Deborah Ann Miller | Nurse Practitioner | 111 W 2nd St, Suite 305, Casper, WY 82601-2464 | 2007-05-03 |
| 1235282120 | Wyoming Neurology P.C. | Nurse Practitioner | 2301 House Ave, Ste 203, Cheyenne, WY 82001-3176 | 2007-01-22 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on POPO AGIE WOMEN'S CLINIC, INC.
| 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.