Healthcare Provider Details

I. General information

NPI: 1871151621
Provider Name (Legal Business Name): KATHERINE ANNE FISHER ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2019
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 JEFFERSON HWY
NEW ORLEANS LA
70121-2451
US

IV. Provider business mailing address

6440 QUEENS COURT TRCE
MABLETON GA
30126-7227
US

V. Phone/Fax

Practice location:
  • Phone: 404-518-0801
  • Fax:
Mailing address:
  • Phone: 404-518-0801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberBOC366719
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number2255A2300X
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: