Individual
KACIE LEANNA FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1560 12TH ST STE 7, ALAMOSA, CO 81101-3709
(719) 589-4906
(719) 589-3034
Mailing address
719 SAN MATEO BLVD NE, ALBUQUERQUE, NM 87108-1434
(505) 485-0464
(505) 266-1017
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
58949
NM
363LW0102X
Women's Health Nurse Practitioner
Primary
C-APN.0001928-C-NP
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42636256
—
NM
01
—
58949
NEW MEXICO LICENSE
NM
05
—
9000182582
—
CO
01
—
C-APN.0001928-C-NP
COLORADO LICENSE
CO
Enumeration date
03/25/2020
Last updated
11/25/2020
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