Healthcare Provider Details

I. General information

NPI: 1669308052
Provider Name (Legal Business Name): FELICIA ANN FISHER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6201 MAYFIELD DR
PINE BLUFF AR
71603-7729
US

IV. Provider business mailing address

6201 MAYFIELD DR
PINE BLUFF AR
71603-7729
US

V. Phone/Fax

Practice location:
  • Phone: 870-692-5236
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: