Individual
MRS. STACY LEANN FISKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
17959 MAIN STREET, EMINENCE, MO 65466
(573) 226-5505
Mailing address
20067 BEARCLAW RD, EUNICE, MO 65468-6804
(417) 247-0677
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2023030046
MO
Other
Enumeration date
08/02/2023
Last updated
08/02/2023
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