IndividualActive
Jackson Devine
NPI 1154251817 · Student in an Organized Health Care Education/Training Program · Laramie, WY
Provider details
- NPI number
- 1154251817
- Entity type
- Individual
- Primary specialty
- Student in an Organized Health Care Education/Training ProgramStudent, Health Care
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Student, Health Care
Practice location
906 S 17th St
Laramie, WY 82070-4713
Phone: (307) 399-6397
Approximate (ZIP-level) locationGet directions
Mailing address
906 S 17th St
Laramie, WY 82070-4713
Registry dates
- Enumerated
- 2026-05-22
- Last updated
- 2026-05-22
- Certified
- 2026-05-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.