Surdam, Amy R

Surdam, Amy R is an individual health care provider with primary practice located at 433 E 19Th St , Cheyenne WY 82001-4643. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Surdam, Amy R can be contacted via phone (307) 635-5393.

Contact Information

Primary practice address
433 E 19Th St Cheyenne WY 82001-4643
Phone: (307) 635-5393
Fax: (307) 635-2199
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 18161.0312 Wyoming

Profile Details

NPI number 1629099312
LBN Legal business name Surdam, Amy R
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2006
Last updated Jun 28th, 2012 - about 14 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 1629099312 NPPES
Wyoming MEDICAID 121544200
Wyoming Other 313763
Wyoming Other P00251860
Wyoming Other 23339
Wyoming Other 82009A055

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