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-- KIM E CLEMETSON -- RN

Individual Provider (NPI-1) Active

Registered Nurse

Provider Information

NPI Number
1700040854
Provider Type
Individual Provider (NPI-1)
Credentials
RN
Status
Active

Contact & Location

Address
29 BLACK COAL DR, FORT WASHAKIE, WY, 82514
Phone
(307) 332-7300
Fax
(307) 332-7464

Specialties & Taxonomies

Registered Nurse Primary License: WY #12788

All Addresses

MAILING

653 BURMA RD

RIVERTON, WY, 825019763

(307) 856-2112

LOCATION

29 BLACK COAL DR

FORT WASHAKIE, WY, 82514

(307) 332-7300