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General NPI Number Information
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NPI Number | 1295804235
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Entity Type | Individual
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Provider Name | VICKI L. FISHER CNP
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Gender | Female
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 11100 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44106-1716
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Country | US
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Telephone | 216-844-1209
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Fax | 216-844-5431
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Provider Business Mailing Address
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Address Line | 1149 GROVE LN
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City | MEDINA
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State | OH
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Zip | 44256-6780
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Country | US
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Telephone | 330-241-4204
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Fax | 216-844-5431
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | NP04323
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License Number State | OH
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