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Individual

MRS. MICAYLA FISHER - IVES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
444 SAINT MICHAELS DR, BLDG A, SANTA FE, NM 87505-7620
(505) 944-4442
(505) 954-4448
Mailing address
125 W WATER ST, SANTA FE, NM 87501-2136
(505) 988-4442
(505) 273-7944

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
682
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1467900829
NPI
NM
Enumeration date
09/14/2016
Last updated
01/09/2017
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