Individual
CHARLES WALTER FISKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
REGISTERED NURSE
Contact information
Practice address
301 ANDREWS AVE, FORT RUCKER, AL 36362
(334) 255-7894
Mailing address
301 ANDREWS AVE, FORT RUCKER, AL 36362
(334) 255-7894
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
503180
NY
163WE0003X
Emergency Registered Nurse
Primary
503180
NY
Other
Enumeration date
04/13/2021
Last updated
04/13/2021
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