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NPI Code Detail

MEDICARE: DANA G FIKE RN

MEDICARE: DANA G FIKE RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse111806TN

General Provider Information

NPI Number : 1023231958
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANA G FIKE RN
Provider Business Mailing Address
First Line : 135 WALKER ST
Second Line :
City : SPARTA
State : TN
Zip : 38583-1725
Country : US
Telephone Number : 931-836-2201
Fax Number : 931-836-3580
Provider Business Practice Location Address
First Line : 135 WALKER ST
Second Line :
City : SPARTA
State : TN
Zip : 38583-1725
Country : US
Telephone Number : 931-836-2201
Fax Number : 931-836-3580
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2007
Last Update Date : 07/08/2007

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