MEDICARE: MS. LESLIE S FIFER ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	ARNP9209238	FL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP30006266	WA
3	363L00000X	Nurse Practitioner	AP30006266	WA

General Provider Information

NPI Number	:	1366430977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LESLIE S FIFER ARNP

Provider Business Mailing Address
First Line	:	PO BOX 4627
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99220-0627
Country	:	US
Telephone Number	:	509-624-1244
Fax Number	:	509-624-1244

Provider Business Practice Location Address
First Line	:	2317 W 3RD AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-5809
Country	:	US
Telephone Number	:	509-624-1244
Fax Number	:	509-624-6240

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2005
Last Update Date	:	04/26/2022

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