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NPI Code Detail

MEDICARE: MS. JOANNE MARIE FISHER F.N.P.

MEDICARE: MS. JOANNE MARIE FISHER F.N.P.
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
1363LF0000XFamily Nurse Practitioner11985CA

General Provider Information

NPI Number : 1467567453
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JOANNE MARIE FISHER F.N.P.
Provider Business Mailing Address
First Line : 161 MESA VERDE ST
Second Line :
City : VALLEJO
State : CA
Zip : 94589-2647
Country : US
Telephone Number : 707-642-8407
Fax Number :
Provider Business Practice Location Address
First Line : 3260 KERNER BLVD
Second Line :
City : SAN RAFAEL
State : CA
Zip : 94901-4861
Country : US
Telephone Number : 415-473-4400
Fax Number : 415-473-6855
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2006
Last Update Date : 01/06/2009

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