Provider Demographics
NPI:1144768474
Name:FISHER, JENNIFER LEIGH (NP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LEIGH
Last Name:FISHER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:INMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSN, ANP, CNM, FNP-C
Mailing Address - Street 1:3300 WILCOX BLVD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-1073
Mailing Address - Country:US
Mailing Address - Phone:423-491-2100
Mailing Address - Fax:423-493-2148
Practice Address - Street 1:3300 WILCOX BLVD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-1073
Practice Address - Country:US
Practice Address - Phone:423-491-2100
Practice Address - Fax:423-493-2148
Is Sole Proprietor?:No
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN22060363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner