Basic Information
| Provider Information | |||||||||
| NPI: | 1477576874 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VOTRUBA | ||||||||
| FirstName: | TROY | ||||||||
| MiddleName: | ELDON | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | CRNA, APRN, MS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 305 19TH ST | ||||||||
| Address2: | |||||||||
| City: | WHEATLAND | ||||||||
| State: | WY | ||||||||
| PostalCode: | 822013140 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3073318174 | ||||||||
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| Practice Location | |||||||||
| Address1: | 111 S 5TH ST | ||||||||
| Address2: | |||||||||
| City: | DOUGLAS | ||||||||
| State: | WY | ||||||||
| PostalCode: | 826332434 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3073582122 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2006 | ||||||||
| LastUpdateDate: | 05/14/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 18540.0832 | WY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.