Fisher, William Shane
Fisher, William Shane is an sole proprietor health care provider with primary practice located at 6005 E Abineau Canyon Dr , Flagstaff AZ 86004-7168. He recently has only one registered license in Nursing & Custodial Care Facilities / Adult Care Home, which is considered as his primary health care specialty. Fisher, William Shane can be contacted via phone (928) 635-6750.Contact Information
Primary practice address
6005 E Abineau Canyon Dr
Flagstaff AZ 86004-7168
Phone: (928) 635-6750
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing & Custodial Care Facilities / Adult Care Home | 311ZA0620X | AL8133H | Arizona |
Profile Details
| NPI number | 1295138568 |
|---|---|
| LBN Legal business name | Fisher, William Shane |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 1st, 2014 |
| Last updated | May 16th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295138568 | NPPES |
| Arizona | MEDICAID | 283460 |
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