Female

Nicole E. Fifer PAC

Physician Assistant in Jacksonville, FL(View on Map)

Full Name

Nicole Elaine Fifer PAC

NPI Number

1861404899

NPI Type

Individual Provider

Gender

Female

Enumeration Date

08/11/2006

Specialties

(Taxonomies)

Code

363A00000X
363AM0700X

Primary Taxonomy

Yes
No

Licenses

State

Florida
Louisiana

License Number

PA9108411
PA200082

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 45443
1400 BISHOP ESTATES RD

City

Salt Lake City
Jacksonville

State

UT
FL

Postal Code

84145-0443
32259-4244

Country

US
US

Telephone Number

(904) 202-1032
(904) 287-2794

Identifiers

Identifier

1013510

Identifier State

LA

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 12/31/2018

Provider Address

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