Provider Demographics
NPI:1093406647
Name:FISK, ERIN LYN (DNP-CRNA)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:LYN
Last Name:FISK
Suffix:
Gender:F
Credentials:DNP-CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1356 NORBY RD
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701-9327
Mailing Address - Country:US
Mailing Address - Phone:213-703-9159
Mailing Address - Fax:
Practice Address - Street 1:1001 MAIN ST STE K3502
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1009
Practice Address - Country:US
Practice Address - Phone:716-323-6576
Practice Address - Fax:716-323-6658
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY660231367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered