Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | NP-06939 | OH |
NPI | 1013926914 |
---|---|
Provider Name | Nancy Fisher |
First Address | Cleveland, OH 44106-1702 |
Second Address | Cleveland, OH 44106-1702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2006 |
Last Update Date | 08/07/2007 |