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NPI Code Detail

MEDICARE: MARY BETH FISHER

MEDICARE: MARY BETH FISHER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner0001107040VA

General Provider Information

NPI Number : 1134144306
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY BETH FISHER
Provider Business Mailing Address
First Line : 451 JAMES MADISON HWY
Second Line : SUITE 104
City : CULPEPER
State : VA
Zip : 22701-2360
Country : US
Telephone Number : 540-727-8880
Fax Number : 540-727-8882
Provider Business Practice Location Address
First Line : 8221 WILLOW OAKS CORPORATE DR # 4425
Second Line :
City : FAIRFAX
State : VA
Zip : 22031-4512
Country : US
Telephone Number : 703-289-7599
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 03/28/2024

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