Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | LE-00035940 | OH |
NPI | 1033794722 |
---|---|
Provider Name | Tonya M Fisher |
First Address | Northfield, OH 44067-4600 |
Second Address | Cleveland, OH 44127-1592 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2021 |
Last Update Date | 14/03/2021 |