| Affinity Family Practice | |
|
903 S Greeley Hwy Ste A Cheyenne WY 82007-3057 | |
| (307) 514-1523 | |
| (307) 514-1526 |
| Full Name | Affinity Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 903 S Greeley Hwy Ste A, Cheyenne, Wyoming |
| Authorized Official Name and Position | Traci Lynn Buran (OWNER AND PROVIDER) |
| Authorized Official Contact | 3075141523 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Affinity Family Practice 903 S Greeley Hwy Ste A Cheyenne WY 82007-3057 Ph: (307) 514-1523 | Affinity Family Practice 903 S Greeley Hwy Ste A Cheyenne WY 82007-3057 Ph: (307) 514-1523 |
| NPI Number | 1255970034 |
|---|---|
| Provider Enumeration Date | 12/27/2019 |
| Last Update Date | 04/30/2020 |
| Medicare PECOS PAC ID | 0749619724 |
|---|---|
| Medicare Enrollment ID | O20200327000415 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255970034 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Sheriedan E Grannan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417326075 PECOS PAC ID: 7315256799 Enrollment ID: I20151026002116 |
| Provider Name | Kelsie Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184266058 PECOS PAC ID: 1355775917 Enrollment ID: I20200107002756 |
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