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General NPI Number Information
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NPI Number | 1083081764
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Entity Type | Individual
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Provider Name | LISA FISHER RNC-OB, IBCLC
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Gender | Female
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Dates
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Enumeration Date | 08/28/2015
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Last Update Date | 08/28/2015
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Provider Practice Location Address
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Address Line | 3401 W GORE BLVD
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City | LAWTON
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State | OK
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Zip | 73505-6332
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Country | US
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Telephone | 580-250-5253
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Fax | 580-585-5478
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Provider Business Mailing Address
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Address Line | 3401 W GORE BLVD
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City | LAWTON
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State | OK
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Zip | 73505-6332
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Country | US
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Telephone | 580-250-5253
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Fax | 580-585-5478
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R118458
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number | 11245984
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 163WX0003X
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Taxonomy Name | Inpatient Obstetric Registered Nurse
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License Number | FIS1-0436-5673
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License Number State | OK
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