Healthcare Provider Details

I. General information

NPI: 1083010029
Provider Name (Legal Business Name): CHANEY FISHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2014
Last Update Date: 12/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 PLEASANT ST
CONCORD NH
03301-3948
US

IV. Provider business mailing address

3 ROYAL CREST DR APT 9
NORTH ANDOVER MA
01845-6409
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-3346
  • Fax: 603-224-2149
Mailing address:
  • Phone: 978-244-0081
  • Fax: 401-921-3327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number296
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: