Individual
MYKA DAWN FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2930 11TH AVE, EVANS, CO 80620-1011
(970) 353-9403
(970) 353-9906
Mailing address
2930 11TH AVE, EVANS, CO 80620-1011
(970) 353-9403
(970) 353-9906
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP 10043
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07654898
—
CO
Enumeration date
06/15/2009
Last updated
06/06/2013
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