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NPI Code Detail

MEDICARE: FANNY T NISBET MD

MEDICARE: FANNY T NISBET MD
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
1208000000XPediatrics Physician20324AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811971021
Entity Type Code : Individual
Provider Name (Legal Business Name) : FANNY T NISBET MD
Provider Business Mailing Address
First Line : 320 W PRINCE RD
Second Line :
City : TUCSON
State : AZ
Zip : 85705-3526
Country : US
Telephone Number : 520-792-9890
Fax Number :
Provider Business Practice Location Address
First Line : 320 W PRINCE RD
Second Line :
City : TUCSON
State : AZ
Zip : 85705-3526
Country : US
Telephone Number : 520-670-3909
Fax Number : 520-388-7170
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2005
Last Update Date : 11/03/2016

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Directions to “ FANNY T NISBET MD” Practice Location

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