Individual provider · NPI-1
Wendy Fisher
Dietitian, Registered · Espanola, NM
NPI number1710397377
StatusActive
Last updated in NPPESMay 5, 2014
Details
- NPI
- 1710397377
- Entity type
- Individual (NPI-1)
- Name
- Wendy Fisher
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 5, 2014
- Last updated
- May 5, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | LD-0910 | NM | Yes |
Practice location
1010 Spruce StEspanola, NM 87532-2724
Phone 505-367-0365 · Fax 505-367-0362
Mailing address
1010 Spruce StEspanola, NM 87532-2724
Phone 505-367-0365
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