Individual
ELAINE C. FIDLER
Active
Individual
ELAINE C. FIDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
006755
PA
363LF0000X
Family Nurse Practitioner
TP005539B
PA
Other
Enumeration date
04/11/2007
Last updated
05/26/2021
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