Healthcare Provider Details

I. General information

NPI: 1366430977
Provider Name (Legal Business Name): LESLIE S FIFER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2317 W 3RD AVE
SPOKANE WA
99201-5809
US

IV. Provider business mailing address

PO BOX 4627
SPOKANE WA
99220-0627
US

V. Phone/Fax

Practice location:
  • Phone: 509-624-1244
  • Fax: 509-624-6240
Mailing address:
  • Phone: 509-624-1244
  • Fax: 509-624-1244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9209238
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP30006266
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP30006266
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: