Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 95014245 | CA |
NPI | 1043822927 |
---|---|
Provider Name | Nisha Nair |
First Address | Fresno, CA 93730-3546 |
Second Address | Fresno, CA 93711-4301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2020 |
Last Update Date | 20/08/2020 |