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General NPI Number Information
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NPI Number | 1245892728
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Entity Type | Individual
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Provider Name | DR. NICOLE FISHER
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Gender | Female
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Dates
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Enumeration Date | 07/03/2019
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Last Update Date | 05/17/2022
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Provider Practice Location Address
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Address Line | 900 E CALGARY AVE
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City | BISMARCK
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State | ND
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Zip | 58503-5616
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Country | US
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Telephone | 701-223-8262
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 ALMOND DR
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City | BISMARCK
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State | ND
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Zip | 58503-8362
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Country | US
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Telephone | 701-471-2329
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 1002149-15
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2407
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License Number State | ND
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