IndividualActive
Duane Mortenson, PA-C
NPI 1578848487 · Physician Assistant · Jackson, WY
Provider details
- NPI number
- 1578848487
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- PA818 (WY)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Physician Assistant363A00000X
Physician Assistants & Advanced Practice Nursing Providers
Practice location
555 E Broadway Ave Ste 207
Jackson, WY 83001-8640
Phone: (307) 733-8002
Fax: (307) 733-0032
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 428
Jackson, WY 83001-0428
Registry dates
- Enumerated
- 2011-10-12
- Last updated
- 2021-05-26
- Certified
- 2021-05-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.