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General NPI Number Information
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NPI Number | 1639941909
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Entity Type | Individual
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Provider Name | ELIZABETH ANN FISHER FNP
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Gender | Female
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Dates
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Enumeration Date | 10/30/2023
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 1200 W MOHAVE RD
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City | PARKER
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State | AZ
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Zip | 85344-6349
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Country | US
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Telephone | 928-669-7380
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Fax | 928-669-7371
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Provider Business Mailing Address
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Address Line | 169 EL DORADO AVE S
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-6064
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Country | US
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Telephone | 951-897-2441
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 276765
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License Number State | AZ
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