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NPI Code Detail

MEDICARE: CARLA K FISHER P.A.-C

MEDICARE:   CARLA K FISHER  P.A.-C
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
1363AM0700XMedical Physician AssistantPA03538TX
2363AM0700XMedical Physician AssistantPA1594NV

General Provider Information

NPI Number : 1396749081
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLA K FISHER P.A.-C
Provider Business Mailing Address
First Line : 4700 LAS VEGAS BLVD N
Second Line :
City : NELLIS AFB
State : NV
Zip : 89191
Country : US
Telephone Number : 702-653-3442
Fax Number :
Provider Business Practice Location Address
First Line : 4700 LAS VEGAS BLVD N
Second Line :
City : NELLIS AFB
State : NV
Zip : 89191-6600
Country : US
Telephone Number : 702-653-3442
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 10/24/2017

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Directions to “ CARLA K FISHER P.A.-C” Practice Location

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