Individual
MICHELLE FIFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1265 UNION AVE, MEMPHIS, TN 38104-3415
(901) 725-5846
Mailing address
6060 PRIMACY PKWY, SUITE 241, MEMPHIS, TN 38119-5745
(901) 725-5846
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
77782
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00121272
—
MS
01
—
3135780
BLUE CROSS
TN
05
—
3626232
—
TN
01
—
430050580
RAILROAD MEDICARE
—
Enumeration date
05/23/2006
Last updated
12/22/2016
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