Individual
BERNADETTE FISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, IBCLC
Contact information
Practice address
331 N 400 W, OREM, UT 84057-1913
(801) 830-0109
Mailing address
PO BOX 254, SALEM, UT 84653-0254
(801) 830-0109
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
3241653102
UT
Other
Enumeration date
11/23/2016
Last updated
11/23/2016
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