Healthcare Provider Details

I. General information

NPI: 1093711780
Provider Name (Legal Business Name): FRANK XAVIER FISHER CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 CONTINENTAL DR SUITE 412
NEWARK DE
19713-4306
US

IV. Provider business mailing address

111 CONTINENTAL DR STE 412
NEWARK DE
19713-4332
US

V. Phone/Fax

Practice location:
  • Phone: 302-709-4497
  • Fax: 302-733-0854
Mailing address:
  • Phone: 302-709-4497
  • Fax: 302-733-0854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN501475L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number26NJ00204400
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NR08622100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: