Basic Information
| Provider Information | |||||||||
| NPI: | 1508347840 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRANQUI DOMINGUEZ | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | CRISTINA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 820 E 17TH ST | ||||||||
| Address2: | |||||||||
| City: | CHEYENNE | ||||||||
| State: | WY | ||||||||
| PostalCode: | 820014714 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3072141580 | ||||||||
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| Practice Location | |||||||||
| Address1: | 820 E 17TH ST | ||||||||
| Address2: | |||||||||
| City: | CHEYENNE | ||||||||
| State: | WY | ||||||||
| PostalCode: | 820014714 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3076322434 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2018 | ||||||||
| LastUpdateDate: | 06/30/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | 194-T1 | WY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.