Provider Demographics
NPI:1043840010
Name:FISER, NATASHA RENEE (LIC ACU)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:RENEE
Last Name:FISER
Suffix:
Gender:F
Credentials:LIC ACU
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 NUNLEY DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-3842
Mailing Address - Country:US
Mailing Address - Phone:512-998-0060
Mailing Address - Fax:
Practice Address - Street 1:1022 16TH AVE S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-2303
Practice Address - Country:US
Practice Address - Phone:615-710-1274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-18
Last Update Date:2020-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNACU0000000348171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist