Provider Demographics
NPI:1164931861
Name:FISHER, LINDSEY WILLARD
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:WILLARD
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 1:381 SADDLERS RUN
Mailing Address - Street 2:
Mailing Address - City:CHESNEE
Mailing Address - State:SC
Mailing Address - Zip Code:29323-8055
Mailing Address - Country:US
Mailing Address - Phone:864-384-1622
Mailing Address - Fax:
Practice Address - Street 1:1905 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29307-2308
Practice Address - Country:US
Practice Address - Phone:864-253-1833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-25
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37412183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist