Individual
TERA ANN FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
120 NOLEN ST, DERIDDER, LA 70634-4522
(337) 396-4095
Mailing address
216 EVANGELINE ST, DERIDDER, LA 70634-4251
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
155695
LA
Other
Enumeration date
02/14/2018
Last updated
02/14/2018
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