Provider Demographics
NPI:1053067041
Name:FISHER, LATARSHA
Entity Type:Individual
Prefix:
First Name:LATARSHA
Middle Name:
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 1:6345 ORCHARD CLUB DR APT 304
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-5371
Mailing Address - Country:US
Mailing Address - Phone:202-821-6261
Mailing Address - Fax:
Practice Address - Street 1:1150 12TH ST NW APT 816
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-4652
Practice Address - Country:US
Practice Address - Phone:202-655-9955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty