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General NPI Number Information
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NPI Number | 1548299753
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Entity Type | Individual
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Provider Name | DELORES MARIE FISCHER RN
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Gender | Female
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 128 E MALLARD DR
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City | BOISE
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State | ID
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Zip | 83706-3975
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Country | US
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Telephone | 208-323-8660
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Fax |
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Provider Business Mailing Address
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Address Line | 10421 LANCELOT AVE
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City | BOISE
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State | ID
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Zip | 83704-5248
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Country | US
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Telephone |
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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 | 163WX1100X
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Taxonomy Name | Ophthalmic Registered Nurse
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License Number | N5834
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License Number State | ID
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