Healthcare Provider Details
I. General information
NPI: 1447612601
Provider Name (Legal Business Name): ANDREA J FISHER APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/25/2016
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10151 DEERWOOD PARK BLVD STE 100
JACKSONVILLE FL
32256-0566
US
IV. Provider business mailing address
1487 BLACK ROCK LN
FARMINGTON MO
63640-7831
US
V. Phone/Fax
- Phone: 800-835-2362
- Fax: 666-784-2818
- Phone: 573-330-2822
- Fax: 866-678-4281
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | CNP241050 |
| License Number State | ME |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | NP500016675 |
| License Number State | DC |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | C-APN.0101735-C-NP |
| License Number State | CO |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 2015042085 |
| License Number State | MO |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | APRN11031179 |
| License Number State | FL |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | A177861 |
| License Number State | IA |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | LG-0012657 |
| License Number State | DE |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 209029828 |
| License Number State | IL |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 306329 |
| License Number State | AZ |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 219309 |
| License Number State | AK |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | APRN-4489 |
| License Number State | HI |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 53-82883-082 |
| License Number State | KS |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 78685 |
| License Number State | ID |
| # 14 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | AC006363 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
