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General NPI Number Information
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NPI Number | 1033297494
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Entity Type | Individual
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Provider Name | NICOLE A FISHER PA
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Gender | Female
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 200 BANNING ST STE 200
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City | DOVER
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State | DE
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Zip | 19904-3487
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Country | US
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Telephone | 302-674-0600
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Fax | 302-672-7144
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Provider Business Mailing Address
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Address Line | 301 LIPPINCOTT DR STE 410
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City | MARLTON
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State | NJ
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Zip | 08053-4197
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Country | US
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Telephone | 302-674-0600
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Fax | 302-672-7144
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | C5-0000341
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License Number State | DE
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