Healthcare Provider Details

I. General information

NPI: 1649394446
Provider Name (Legal Business Name): MRS. BRENDA PATRICIA FISHER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 SHELTER COVE LN
HILTON HEAD ISLAND SC
29928-3543
US

IV. Provider business mailing address

42 SHELTER COVE LN
HILTON HEAD ISLAND SC
29928-3543
US

V. Phone/Fax

Practice location:
  • Phone: 843-842-0550
  • Fax: 843-842-0556
Mailing address:
  • Phone: 843-842-0550
  • Fax: 843-842-0556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number11902
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: