Healthcare Provider Details

I. General information

NPI: 1144279845
Provider Name (Legal Business Name): J. MEREINDA FISHER LM-CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 05/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 MADISON CREEK COURT
LYMAN SC
29365-3726
US

IV. Provider business mailing address

409 MADISON CREEK CT
LYMAN SC
29365-1254
US

V. Phone/Fax

Practice location:
  • Phone: 864-354-8166
  • Fax:
Mailing address:
  • Phone: 864-354-8166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number08
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: