Provider Demographics
NPI:1114690864
Name:FISHER, LAUREN PAIGE
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:PAIGE
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 1:4925 STANBURY CIR NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-9579
Mailing Address - Country:US
Mailing Address - Phone:330-409-5818
Mailing Address - Fax:
Practice Address - Street 1:4925 STANBURY CIR NW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-9579
Practice Address - Country:US
Practice Address - Phone:330-409-5818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program