Provider Demographics
NPI:1922321124
Name:FISKE, NADINE NIZIOLEK (APN)
Entity Type:Individual
Prefix:MRS
First Name:NADINE
Middle Name:NIZIOLEK
Last Name:FISKE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 W. 14TH STREET
Mailing Address - Street 2:JOINT REPLACEMENT CENTER
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19899
Mailing Address - Country:US
Mailing Address - Phone:302-428-4123
Mailing Address - Fax:
Practice Address - Street 1:501 W. 14TH STREET
Practice Address - Street 2:JOINT REPLACEMENT CENTER
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-1013
Practice Address - Country:US
Practice Address - Phone:302-428-4123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-03
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELB-0000223363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner