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General NPI Number Information
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NPI Number | 1932918240
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Entity Type | Individual
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Provider Name | KASEY JO FISHLEY AGNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/01/2025
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Last Update Date | 01/01/2025
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Provider Practice Location Address
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Address Line | PO BOX 453
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City | MINERAL CITY
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State | OH
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Zip | 44656-0453
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Country | US
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Telephone | 330-204-4608
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 453
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City | MINERAL CITY
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State | OH
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Zip | 44656-0453
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Country | US
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Telephone | 330-204-4608
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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 | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | APRN.CNP.0038313
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License Number State | OH
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