Provider Demographics
NPI:1205245107
Name:FISHEL, EMILI ARMANDA
Entity type:Individual
Prefix:MRS
First Name:EMILI
Middle Name:ARMANDA
Last Name:FISHEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EMILI
Other - Middle Name:ARMANDA
Other - Last Name:DE BARROS VIEIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:130 LOGAN ST
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66048-4612
Mailing Address - Country:US
Mailing Address - Phone:315-489-0165
Mailing Address - Fax:
Practice Address - Street 1:130 LOGAN ST
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-4612
Practice Address - Country:US
Practice Address - Phone:315-489-0165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS201831376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide