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General NPI Number Information
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NPI Number | 1487025615
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Entity Type | Individual
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Provider Name | TONYA RENEE FISHER CNP
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Gender | Female
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Dates
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Enumeration Date | 10/14/2015
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 3911 STONEGATE PARK
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City | SAINT JOSEPH
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State | MI
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Zip | 49085-9130
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Country | US
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Telephone | 269-408-1777
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Fax | 269-408-1755
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Provider Business Mailing Address
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Address Line | 1483 COUNTRY KNOLL PL
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City | SAINT JOSEPH
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State | MI
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Zip | 49085-9491
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Country | US
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Telephone | 847-345-9522
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Fax | 269-408-1755
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 041.316748
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209013250
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704355252
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704355252
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License Number State | MI
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