Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QS0010X | Family Doctor - Sports Medicine | 0035644 | CO |
Y | 207QS0010X | Family Doctor - Sports Medicine | 035644 | CO |
NPI | 1316983265 |
---|---|
Provider Name | Dr. Nikita T. Vischer |
First Address | Fort Collins, CO 80525-9718 |
Second Address | Fort Collins, CO 80525-9718 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 24/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01356443 | (05) | CO |
G37088 | (02) |