NPI 1679336812

Evernorth Care Providers - Arizona PC

Organisation General Practice Physician Cheyenne, WY

Practice location

Address: 1603 Capitol Ave STE 510d, Cheyenne, WY 82001-4563
Phone: (773) 292-4800
Fax: (312) 564-4059
Mailing address: 730 Cool Springs Blvd STE 500, Franklin, TN 37067-7331

Authorised official

Name: Grace Blue
Title: Credentialing Sr. Manager
Phone: (773) 292-4800

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X

Other General Practice providers in Wyoming →

Registry record

NPI: 1679336812
Entity type: Organization
NPI issued: 31 Jan 2024
Record last updated: 31 Jan 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.