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NPI Code Detail

MEDICARE: JENNIFER S FISHER OT

MEDICARE:   JENNIFER S FISHER  OT
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
1225X00000XOccupational Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
131003231AOTHERININDIANA LICENSE

General Provider Information

NPI Number : 1588362727
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER S FISHER OT
Provider Business Mailing Address
First Line : 13616 TUSCON PASS
Second Line :
City : FORT WAYNE
State : IN
Zip : 46814-8865
Country : US
Telephone Number : 919-720-1994
Fax Number :
Provider Business Practice Location Address
First Line : 13616 TUSCON PASS
Second Line :
City : FORT WAYNE
State : IN
Zip : 46814-8865
Country : US
Telephone Number : 919-720-1994
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2023
Last Update Date : 02/14/2025

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Directions to “ JENNIFER S FISHER OT” Practice Location

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