Equality State Infection Foundation

NPI #1104062314 in Casper, Wyoming

Provider Information

NPI Number: 1104062314
Entity Type: Organization
Organization Name: Equality State Infection Foundation
Primary Specialty: Internal Medicine - Infectious Disease
Enumeration Date: Dec 18, 2008
Last Updated: Dec 18, 2008

Practice Location

Address: 5810 E 2ND ST STE 200
City: Casper
State: Wyoming
ZIP Code: 82609-4330
Phone: (307) 234-8710

Authorized Official

Name: MS. LISA MARIE WILLETTE, RN
Title: COO, CFO
Phone: (307) 234-8710

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dietitian, Registered	133V00000X
Registered Nurse - Case Management — Case Management	163WC0400X
Counselor	101Y00000X
Early Intervention Provider Agency	252Y00000X
Internal Medicine - Infectious Disease — Infectious Disease	207RI0200X	Primary

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