Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Evernorth Care Providers - Arizona PC

Organization General Practice Physician · NPI 1679336812

Evernorth Care Providers - Arizona PC is a General Practice Physician in Cheyenne, Wyoming. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1603 Capitol Ave Ste 510D
Cheyenne, WY 82001-4563
Phone: (773) 292-4800
Fax: (312) 564-4059
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X

Record details

NPI number1679336812
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Grace Blue — Credentialing Sr. Manager · (773) 292-4800
NPI enumeratedJanuary 31, 2024
Last updated in NPPESJanuary 31, 2024
Certification dateJanuary 31, 2024
Mailing address730 Cool Springs Blvd Ste 500, Franklin, TN 37067-7331

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