Healthcare Provider Details

I. General information

NPI: 1144843673
Provider Name (Legal Business Name): JOHNNA FISHER APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOHNNA DIAZ

II. Dates (important events)

Enumeration Date: 05/19/2020
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21245 LORAIN RD
FAIRVIEW PARK OH
44126-2146
US

IV. Provider business mailing address

21245 LORAIN RD
FAIRVIEW PARK OH
44126-2146
US

V. Phone/Fax

Practice location:
  • Phone: 440-949-9835
  • Fax:
Mailing address:
  • Phone: 440-949-9835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0296750
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: