Individual provider · Type 1 NPI
Mitzie Ralph Fairfield, NP
Women's Health Nurse Practitioner · Champaign, IL
NPI number
1063580058
Active
Practice location
302 E. Stoughton
Champaign, IL 61820
Mailing address
615 County Rd 3400 North
Foosland, IL 61845
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Women's Health Nurse Practitioner Primary | 363LW0102X | 209-000689 (IL) |
Women's Health Nurse Practitioner: Definition to come...
Other women's health nurse practitioner providers in Champaign
About NPI 1063580058
Mitzie Ralph Fairfield, NP's National Provider Identifier is 1063580058, issued on Nov 30, 2006. The primary taxonomy on file is Women's Health Nurse Practitioner (363LW0102X), and the practice location is in Champaign, IL. The record was last updated on Oct 24, 2008.