Provider Demographics
NPI:1275708646
Name:FISHER, TISHA BRITTAIN (FNP-C)
Entity Type:Individual
Prefix:
First Name:TISHA
Middle Name:BRITTAIN
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 1:3975 ROBINSON RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NC
Mailing Address - Zip Code:28658-9715
Mailing Address - Country:US
Mailing Address - Phone:828-466-0466
Mailing Address - Fax:828-466-8862
Practice Address - Street 1:3975 ROBINSON RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NC
Practice Address - Zip Code:28658-9715
Practice Address - Country:US
Practice Address - Phone:828-466-0466
Practice Address - Fax:828-466-8862
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201410363L00000X, 363LF0000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC154H7OtherBCBS
NC201410OtherNP LICENSE
NC2315894OtherMEDICARE GROUP NUMBER
NC0213MOtherBLUE CROSS BLUE SHIELD GROUP NUMBER
NC145780OtherRN LICENSE
NC154H7OtherBLUE CROSS BLUE SHIELD INDIVIDUAL PROVIDER NUMBER
NC890213MOtherMEDICAID GROUP NUMBER
NC890213MOtherMEDICAID GROUP NUMBER
NCMG0619671OtherDEA