Bourlier-Childress, Joann

Bourlier-Childress, Joann is an individual health care provider with primary practice located at 214 E 23Rd St , Cheyenne WY 82001-3748. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Bourlier-Childress, Joann can be contacted via phone (307) 634-2273.

Contact Information

Primary practice address
214 E 23Rd St Cheyenne WY 82001-3748
Phone: (307) 634-2273
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X NE692 Nebraska
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 463 Wyoming

Profile Details

NPI number 1063491892
LBN Legal business name Bourlier-Childress, Joann
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 11th, 2006
Last updated Jan 13th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063491892 NPPES
Colorado MEDICAID 49876317
Colorado MEDICAID NE692

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