Provider Demographics
NPI:1073094959
Name:FISHER, MADELAINE MARIE (PA)
Entity Type:Individual
Prefix:
First Name:MADELAINE
Middle Name:MARIE
Last Name:FISHER
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:9097 E DESERT COVE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6280
Mailing Address - Country:US
Mailing Address - Phone:480-273-8510
Mailing Address - Fax:480-214-9933
Practice Address - Street 1:395 N SILVERBELL RD STE 201
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2719
Practice Address - Country:US
Practice Address - Phone:520-792-2170
Practice Address - Fax:520-792-9702
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2020-10-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical