| Amy R Surdam, NP | |
|
433 E 19th St, Cheyenne, WY 82001-4643 | |
| (307) 635-5393 | |
| (307) 635-2199 |
| Full Name | Amy R Surdam |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Location | 433 E 19th St, Cheyenne, Wyoming |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629099312 | NPI | - | NPPES |
| 121544200 | Medicaid | WY | |
| 313763 | Other | WY | BLUE SHIELD |
| P00251860 | Other | WY | RAILROAD MEDICARE |
| 23339 | Other | WY | WINHEALTH PARTNERS |
| 82009A055 | Other | WY | WPS TRIWEST |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 18161.0312 (Wyoming) | Primary |
| Entity Name | Care United Medical Center Of Laramie Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063720605 PECOS PAC ID: 7719168491 Enrollment ID: O20110301000527 |
| Entity Name | Instaclinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659978401 PECOS PAC ID: 2769894997 Enrollment ID: O20201212000212 |
| Mailing Address | Practice Location Address |
|---|---|
| Amy R Surdam, NP Po Box 20170, Cheyenne, WY 82003-7004 Ph: (307) 635-5393 | Amy R Surdam, NP 433 E 19th St, Cheyenne, WY 82001-4643 Ph: (307) 635-5393 |
Christy Marie Burd, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2029 Bluegrass Cir Ste 200, Cheyenne, WY 82009 Phone: 307-638-8975 | |
Mrs. Diane E Hattel, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3235 Sparks Rd, Suite 200, Cheyenne, WY 82001 Phone: 307-638-8975 Fax: 307-634-9267 | |
Penny Marie Sanderson, APRN, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2500 Dell Range Blvd, Cheyenne, WY 82009 Phone: 307-630-4729 Fax: 307-632-3298 | |
Julian Good, FNP, PMHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 510 W 29th St, Cheyenne, WY 82001 Phone: 330-763-2936 Fax: 307-637-6852 | |
Daniel Taylor West, AGNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 214 E 23rd St, Cheyenne, WY 82001 Phone: 307-634-2273 | |
Jannene Sneddon Sebesta, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 214 E 23rd St, Cheyenne, WY 82001 Phone: 307-633-7952 Fax: 307-633-7018 | |
Megan Lynn Bade, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 611 E Carlson St Ste 102, Cheyenne, WY 82009 Phone: 307-316-5026 |