Provider Demographics
NPI:1306814751
Name:FISHER, LINDA JEAN (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:JEAN
Last Name:FISHER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4575 TOWNSHIP ROAD 126
Mailing Address - Street 2:
Mailing Address - City:CARDINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43315-9584
Mailing Address - Country:US
Mailing Address - Phone:419-946-1793
Mailing Address - Fax:419-947-3320
Practice Address - Street 1:4575 TOWNSHIP ROAD 126
Practice Address - Street 2:
Practice Address - City:CARDINGTON
Practice Address - State:OH
Practice Address - Zip Code:43315-9584
Practice Address - Country:US
Practice Address - Phone:419-946-1793
Practice Address - Fax:419-947-3320
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNA04734367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered