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NPI Code Detail

MEDICARE: BRENDA K FISH

MEDICARE: BRENDA K FISH
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN.CNP.17222OH
2363LP0808XPsychiatric/Mental Health Nurse Practitioner0024190494VA
3363LG0600XGerontology Nurse Practitioner0024190494VA

General Provider Information

NPI Number : 1447638325
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDA K FISH
Provider Business Mailing Address
First Line : 11986 DOLT RD
Second Line :
City : DELPHOS
State : OH
Zip : 45833-8952
Country : US
Telephone Number : 419-235-3801
Fax Number :
Provider Business Practice Location Address
First Line : 230 BROWNS WAY RD
Second Line :
City : MIDLOTHIAN
State : VA
Zip : 23114-9501
Country : US
Telephone Number : 804-419-9101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2015
Last Update Date : 02/05/2026

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