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General NPI Number Information
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NPI Number | 1629564695
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Entity Type | Individual
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Provider Name | TIMOTHY SCOTT FISHER JR. CRNP
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Gender | Male
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Dates
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Enumeration Date | 07/02/2018
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 2025 TECHNOLOGY PKWY STE 207
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City | MECHANICSBURG
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State | PA
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Zip | 17050-9402
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Country | US
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Telephone | 717-988-0611
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Fax | 717-231-8778
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Provider Business Mailing Address
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Address Line | 2025 TECHNOLOGY PKWY STE 207
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City | MECHANICSBURG
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State | PA
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Zip | 17050-9402
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Country | US
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Telephone | 717-988-0611
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Fax | 717-231-8778
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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 | 641588
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP019178
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License Number State | PA
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