Individual
FABIENNE FIFY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1700 I ST, LA PORTE, IN 46350-5750
(708) 288-5036
Mailing address
1118 W 112TH PL, CHICAGO, IL 60643-4518
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
71015257A
IN
363LG0600X
Gerontology Nurse Practitioner
Primary
MF9072769
IN
Other
Enumeration date
04/01/2024
Last updated
03/01/2025
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