IndividualActive
Ellen Kingdom, PA-C
NPI 1508480542 · Physician Assistant · Cheyenne, WY
Provider details
- NPI number
- 1508480542
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- PA.0006279 (CO)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
2301 House Ave Ste 502
Cheyenne, WY 82001-3179
Phone: (307) 635-4131
Approximate (ZIP-level) locationGet directions
Mailing address
2301 House Ave Ste 502
Cheyenne, WY 82001-3179
Registry dates
- Enumerated
- 2020-06-05
- Last updated
- 2020-12-04
- Certified
- 2020-10-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.