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Provider Information for 1871710921


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Mrs. NIKOLE R. FISHER MSW, LCSW


Other Names:  
Former Name: 
Miss NIKOLE R. NETTLES MSW

Sex: Female

NPI: 1871710921
Last Updated: 2011-06-02
Certification Date:

Details

NameValue
NPI1871710921
Enumeration Date2007-04-19
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 755 W CARMEL DR
212
CARMEL, IN 46032-5877
United States

Phone: 317-569-4533 | Fax:317-569-1767
 
Primary Practice Address 755 W CARMEL DR
212
CARMEL, IN 46032-5877
United States

Phone: 317-569-4533 | Fax:317-569-1767
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDIN200939800A
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 1041C0700X - Social Worker - ClinicalIN34006204A