Healthcare Provider Details

I. General information

NPI: 1144623570
Provider Name (Legal Business Name): JULIE FISHER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2014
Last Update Date: 09/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 PARKCHESTER BAY UNIT B
SPRING CREEK NV
89815
US

IV. Provider business mailing address

307 PARKCHESTER BAY UNIT B
SPRING CREEK NV
89815
US

V. Phone/Fax

Practice location:
  • Phone: 775-388-2478
  • Fax:
Mailing address:
  • Phone: 775-388-2478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: