Healthcare Provider Details

I. General information

NPI: 1023083334
Provider Name (Legal Business Name): JULIE FISHER CURRENT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 BEARD CREEK ROAD SUITE 200
EDWARDS CO
81632
US

IV. Provider business mailing address

PO BOX 1749
EDWARDS CO
81632-1749
US

V. Phone/Fax

Practice location:
  • Phone: 970-926-6340
  • Fax: 970-926-6348
Mailing address:
  • Phone: 970-926-6340
  • Fax: 970-926-6348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2008
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: