Individual
MRS. MYRNA CLARE FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APPN
Contact information
Practice address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 514-2500
(208) 375-2217
Mailing address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 514-2500
(208) 375-2217
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP193A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0043801
—
ID
05
—
1306839741
—
ID
Enumeration date
08/30/2005
Last updated
08/01/2014
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