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General NPI Number Information
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NPI Number | 1831462100
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Entity Type | Individual
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Provider Name | JANE NOEL FISK CRNP
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Gender | Female
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Dates
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Enumeration Date | 02/17/2012
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Last Update Date | 02/17/2012
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Provider Practice Location Address
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Address Line | 701 OSTRUM ST SUITE 602
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City | FOUNTAIN HILL
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State | PA
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Zip | 18015-1155
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Country | US
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Telephone | 610-865-5888
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Fax | 610-865-1697
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Provider Business Mailing Address
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Address Line | 3407 FREEMANSBURG AVE
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City | EASTON
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State | PA
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Zip | 18045-5104
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Country | US
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Telephone | 610-252-2365
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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 | SP011791
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License Number State | PA
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