Provider Demographics
NPI:1275228215
Name:FISHER, JOHN KEVIN
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:KEVIN
Last Name:FISHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8658 APPLE BLOSSOM LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45244-4314
Mailing Address - Country:US
Mailing Address - Phone:513-545-5038
Mailing Address - Fax:
Practice Address - Street 1:8658 APPLE BLOSSOM LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45244-4314
Practice Address - Country:US
Practice Address - Phone:513-545-5038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No347C00000XTransportation ServicesPrivate Vehicle