Provider Demographics
NPI:1083936652
Name:FISHER, DEBRA SUE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:SUE
Last Name:FISHER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17068 FISH DAUM RD
Mailing Address - Street 2:
Mailing Address - City:RICHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:43344
Mailing Address - Country:US
Mailing Address - Phone:740-815-5784
Mailing Address - Fax:
Practice Address - Street 1:17068 FISH DAUM RD
Practice Address - Street 2:
Practice Address - City:RICHWOOD
Practice Address - State:OH
Practice Address - Zip Code:43344-9743
Practice Address - Country:US
Practice Address - Phone:740-815-5784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN127257164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse