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NPI Code Detail

MEDICARE: TINA M FISHER NP

MEDICARE: TINA M FISHER NP
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 PractitionerLG0000754DE
2363L00000XNurse Practitioner26NJ00697000NJ

General Provider Information

NPI Number : 1215312087
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA M FISHER NP
Provider Business Mailing Address
First Line : 200 HYGEIA DR
Second Line : SUITE 2300
City : NEWARK
State : DE
Zip : 19713-2049
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 125 EAST AVE
Second Line : SUITE C
City : WOODSTOWN
State : NJ
Zip : 08098-1351
Country : US
Telephone Number : 856-769-4256
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2015
Last Update Date : 02/17/2017

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