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Individual

WANDA FISHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
485 MOCKINGBIRD LN, MADISON, MS 39110-9577
(601) 906-1678
Mailing address
485 MOCKINGBIRD LN, MADISON, MS 39110-9577
(601) 906-1678

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R672181
MS

Other

Enumeration date
10/10/2014
Last updated
10/10/2014
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