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General NPI Number Information
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NPI Number | 1235194903
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Entity Type | Individual
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Provider Name | JOANN FISHER ARNP
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Gender | Female
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 04/23/2014
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Provider Practice Location Address
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Address Line | 6320 VENTURE DR SUITE 205
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34202-5130
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Country | US
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Telephone | 941-924-9955
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Fax | 941-924-5165
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Provider Business Mailing Address
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Address Line | 6320 VENTURE DR SUITE 205
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34202-5130
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Country | US
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Telephone | 941-924-9955
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Fax | 941-924-5165
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | ARNP1072712
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License Number State | FL
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