IndividualActive
Tristyn Richendifer, PA-C
NPI 1265816466 · Surgical Physician Assistant · Douglas, WY
Provider details
- NPI number
- 1265816466
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- Yes
- License
- PT639 (WY)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
111 S 5th St
Douglas, WY 82633-2434
Phone: (307) 358-6200
Approximate (ZIP-level) locationGet directions
Mailing address
808 Riverbend Dr
Douglas, WY 82633-2054
Registry dates
- Enumerated
- 2015-07-17
- Last updated
- 2022-08-03
- Certified
- 2022-08-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.