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General NPI Number Information
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NPI Number | 1417105081
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Entity Type | Individual
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Provider Name | COLLEEN YVONNE FISHER R.N.
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Gender | Female
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Dates
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Enumeration Date | 09/08/2008
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Last Update Date | 09/08/2008
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Provider Practice Location Address
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Address Line | 9014 STATE ROUTE 3 WEST
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City | CLARKSVILLE
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State | OH
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Zip | 45113
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Country | US
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Telephone | 937-302-9230
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Fax | 937-289-4236
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Provider Business Mailing Address
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Address Line | 9014 U.S. HIGHWAY 22 WEST
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City | CLARKSVILLE
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State | OH
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Zip | 45113
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Country | US
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Telephone | 937-302-9230
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Fax | 937-289-4236
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN188503
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License Number State | OH
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