| Marisha Lee Vanvleet, APRN-CNP, PMHNP-BC | |
|
724 Front St Ste 404, Evanston, WY 82930-3589 | |
| (307) 288-2328 | |
| (307) 448-4606 |
| Full Name | Marisha Lee Vanvleet |
|---|---|
| Gender | Female |
| Speciality | Clinical Nurse Specialist - Psychiatric/mental Health |
| Location | 724 Front St Ste 404, Evanston, Wyoming |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730856147 | NPI | - | NPPES |
| 114001 | Other | NE | 2ND APRN LICENS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 364SP0808X | Clinical Nurse Specialist - Psychiatric/mental Health | 32026 (Wyoming) | Primary |
| Entity Name | Silver Sage Psychiatry Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619629912 PECOS PAC ID: 9739573312 Enrollment ID: O20220224000735 |
| Mailing Address | Practice Location Address |
|---|---|
| Marisha Lee Vanvleet, APRN-CNP, PMHNP-BC 724 Front St Ste 404, Evanston, WY 82930-3589 Ph: (307) 228-2328 | Marisha Lee Vanvleet, APRN-CNP, PMHNP-BC 724 Front St Ste 404, Evanston, WY 82930-3589 Ph: (307) 288-2328 |
James Patrick Fleenor, ANP Clinical Nurse Specialist Medicare: Accepting Medicare Assignments Practice Location: 831 Highway 150 S, Evanston, WY 82930 Phone: 307-789-3464 Fax: 307-789-7373 | |
Raymond Hans Benson, PMHNP Clinical Nurse Specialist Medicare: Medicare Enrolled Practice Location: 190 Arrowhead Dr, Evanston, WY 82930 Phone: 307-789-3636 | |
Tamara Sue Bach, FNP-BC Clinical Nurse Specialist Medicare: Accepting Medicare Assignments Practice Location: 195 Feather Way Ste 100, Evanston, WY 82930 Phone: 307-200-9200 Fax: 307-200-4808 | |
Mr. Eric G Roman, NP Clinical Nurse Specialist Medicare: Medicare Enrolled Practice Location: 831 Highway 150 S, Evanston, WY 82930 Phone: 307-789-3464 Fax: 307-789-7373 |