MEDICARE: JESSICA FRANCISCO FISHER PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	0010-00711	NC

General Provider Information

NPI Number	:	1457498529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA FRANCISCO FISHER PA

Provider Business Mailing Address
First Line	:	6419 CAROLINA BEACH RD
Second Line	:	SUITE A
City	:	WILMINGTON
State	:	NC
Zip	:	28412-2909
Country	:	US
Telephone Number	:	910-790-3660
Fax Number	:	910-790-9499

Provider Business Practice Location Address
First Line	:	6419 CAROLINA BEACH RD
Second Line	:	SUITE A
City	:	WILMINGTON
State	:	NC
Zip	:	28412-2909
Country	:	US
Telephone Number	:	910-790-3660
Fax Number	:	910-790-9499

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	06/01/2012

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Directions to “ JESSICA FRANCISCO FISHER PA” Practice Location

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