Healthcare Provider Details
I. General information
NPI: 1194375972
Provider Name (Legal Business Name): KARA SUTTON FRENCH FISHER FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/13/2019
Last Update Date: 11/22/2021
Certification Date: 11/22/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13800 HULL STREET RD
MIDLOTHIAN VA
23112-2002
US
IV. Provider business mailing address
13800 HULL STREET RD
MIDLOTHIAN VA
23112-2002
US
V. Phone/Fax
- Phone: 804-739-2198
- Fax:
- Phone: 47-392-1988
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 0024176857 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: