Provider Demographics
NPI:1093101099
Name:FISHER, BETH (MSN, RN)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:FISHER
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 LEWIS DR
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-4020
Mailing Address - Country:US
Mailing Address - Phone:785-625-3257
Mailing Address - Fax:785-625-8557
Practice Address - Street 1:94 LEWIS DR
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-4020
Practice Address - Country:US
Practice Address - Phone:785-625-3257
Practice Address - Fax:785-625-8557
Is Sole Proprietor?:No
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-37929-112163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse