MEDICARE: LAURIE P FISHMAN APN

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	363LN0005X	Critical Care Neonatal Nurse Practitioner	APN000893	NV
2	363LN0000X	Neonatal Nurse Practitioner	APN000893	NV

General Provider Information

NPI Number	:	1730299215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURIE P FISHMAN APN

Provider Business Mailing Address
First Line	:	3196 S MARYLAND PKWY
Second Line	:	SUITE 217
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2305
Country	:	US
Telephone Number	:	702-733-4944
Fax Number	:

Provider Business Practice Location Address
First Line	:	3196 S MARYLAND PKWY
Second Line	:	SUITE 217
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2305
Country	:	US
Telephone Number	:	702-733-4944
Fax Number	:

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	03/21/2012

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Directions to “ LAURIE P FISHMAN APN” Practice Location

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