Provider Demographics
NPI:1215546494
Name:FISHER, VANESSA F (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:F
Last Name:FISHER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 ANDERSON DR STE 203
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-1055
Mailing Address - Country:US
Mailing Address - Phone:907-382-9000
Mailing Address - Fax:
Practice Address - Street 1:1020 ANDERSON DR STE 203
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-1055
Practice Address - Country:US
Practice Address - Phone:360-533-6063
Practice Address - Fax:360-533-2204
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-23
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61080524363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner