Provider Demographics
NPI:1326128059
Name:FISHER, LAURA G (CRNA)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:G
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:PO BOX 932840
Mailing Address - Street 2:WINDY HILL ANESTHESIA ASSOCIATES PC
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-2840
Mailing Address - Country:US
Mailing Address - Phone:800-749-2940
Mailing Address - Fax:706-660-9390
Practice Address - Street 1:2540 WINDY HILL ROAD
Practice Address - Street 2:WINDY HILL HOSPITAL
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067
Practice Address - Country:US
Practice Address - Phone:770-644-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2012-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN076869367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA322902OtherWELLCARE
GA000632849ACMedicaid
GAGRP757OtherMEDICARE GROUP
GAGRP757OtherMEDICARE GROUP
GA000632849ACMedicaid