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General NPI Number Information
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NPI Number | 1063147551
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Entity Type | Organization
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Legal Business Name | FISHER MOBILE AUDIOLOGY
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Dates
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Enumeration Date | 07/19/2022
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Last Update Date | 07/19/2022
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Provider Practice Location Address
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Address Line | 1809 S GLASGOW AVE
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City | NAMPA
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State | ID
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Zip | 83686-4853
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Country | US
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Telephone | 208-340-1482
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Fax |
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Provider Business Mailing Address
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Address Line | 1809 S GLASGOW AVE
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City | NAMPA
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State | ID
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Zip | 83686-4853
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Country | US
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Telephone | 208-340-1482
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF AUDIOLOGY
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Name | DR. MARIA LYNN FISHER
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Credential | AU.D.
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Telephone | 208-340-1482
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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