MS. MITZIE RALPH FAIRFIELD NP NPI 1063580058

NPI Information

  • NPI: 1063580058
  • Provider Name: MS. MITZIE RALPH FAIRFIELD, NP
  • Classification: Nurse Practitioner - 363LW0102X
  • Specialization: Women's Health
  • Entity Type: Individual
  • Address: 302 E. STOUGHTON
    CHAMPAIGN, IL
    ZIP 61820
  • Phone: (217) 359-8022

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NPI Details

MS. Mitzie Ralph Fairfield, NP is a women's health nurse practitioner in Champaign, IL. MS. Mitzie Ralph Fairfield, NP NPI is 1063580058. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

302 E. STOUGHTON
CHAMPAIGN, IL
ZIP 61820
Phone: (217) 359-8022

The enumeration date for this NPI number is 11/30/2006 and was last updated on 10/24/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LW0102XNurse PractitionerWomen's Health209-000689ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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