Individual
DR. SYRAH ELIZABETH NICAISSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
88 MDG/SGHJ, 4881 SUGAR MAPLE DR., 88 MDG, WRIGHT PATTERSON AIR FORCE BASE, OH 45433
(937) 257-8729
Mailing address
88 MDG/SGHJ, 4881 SUGAR MAPLE DR., WPAFB, OH 45433
(937) 257-8729
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
CNM0235
VA
Other
Enumeration date
11/01/2010
Last updated
07/14/2022
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