Healthcare Provider Details

I. General information

NPI: 1831647973
Provider Name (Legal Business Name): CASEY A FISHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2016
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 8TH ST NE ANESTHESIA DEPARTMENT
MASSILLON OH
44646-8503
US

IV. Provider business mailing address

334 LEATHERMAN RD
WADSWORTH OH
44281-8415
US

V. Phone/Fax

Practice location:
  • Phone: 330-832-8761
  • Fax:
Mailing address:
  • Phone: 330-714-9208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number24484
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number111938
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: