Healthcare Provider Details

I. General information

NPI: 1356360150
Provider Name (Legal Business Name): MELANIE C FISHER APRN- CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 06/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 WINN WAY DEKALB CRISIS CENTER
DECATUR GA
30030
US

IV. Provider business mailing address

872 WOODLAND AVE SE
ATLANTA GA
30316-2427
US

V. Phone/Fax

Practice location:
  • Phone: 404-294-0499
  • Fax:
Mailing address:
  • Phone: 404-627-9551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberRN055758 CNS/PMH
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: