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NPI 1225143423

NPI 1225143423 : JOSEPH D FISHER CNP : CANTON, OH

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General NPI Number Information
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    NPI Number           |    1225143423
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    Entity Type          |    Individual 
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    Provider Name        |    JOSEPH D FISHER CNP
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/20/2006
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    Last Update Date     |    11/11/2015
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Provider Practice Location Address
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    Address Line         |    4048 DRESSLER RD NW SUITE 100
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    City                 |    CANTON
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    State                |    OH
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    Zip                  |    44718-2784
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    Country              |    US
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    Telephone            |    330-479-3333
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    Fax                  |    330-479-3334
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Provider Business Mailing Address
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    Address Line         |    4048 DRESSLER RD NW SUITE 100
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    City                 |    CANTON
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    State                |    OH
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    Zip                  |    44718-2784
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    Country              |    US
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    Telephone            |    330-479-3333
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    Fax                  |    330-479-3334
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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        |    363LA2200X
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    Taxonomy Name        |    Adult Health Nurse Practitioner
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    License Number       |    NP04950
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    License Number State |    OH
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Taxonomy #2
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    Taxonomy Code        |    363LF0000X
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    Taxonomy Name        |    Family Nurse Practitioner
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    License Number       |    NP04950
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    License Number State |    OH
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