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General NPI Number Information
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NPI Number | 1437853413
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Entity Type | Individual
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Provider Name | TAYLOR FISHER PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/27/2023
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 3200 WESTHILL DR STE 102
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City | WAUSAU
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State | WI
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Zip | 54401-4706
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Country | US
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Telephone | 920-284-9612
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Fax |
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Provider Business Mailing Address
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Address Line | N1686 MEDINA DR
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City | GREENVILLE
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State | WI
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Zip | 54942-8303
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Country | US
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Telephone |
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 7949-23
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License Number State | WI
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