Provider Demographics
NPI:1033794722
Name:FISHER, TONYA M
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:M
Last Name:FISHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7998 SUMMERSWEET TRL
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44067-4600
Mailing Address - Country:US
Mailing Address - Phone:216-469-4582
Mailing Address - Fax:
Practice Address - Street 1:5500 RIDGE RD STE 138
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-2367
Practice Address - Country:US
Practice Address - Phone:440-340-5209
Practice Address - Fax:216-243-9979
Is Sole Proprietor?:No
Enumeration Date:2021-03-14
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0028620363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health