Provider Demographics
NPI:1326752841
Name:FISHER, KATHRYN (RN)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:
Last Name:FISHER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85448 MOLVENA DR
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92203-8300
Mailing Address - Country:US
Mailing Address - Phone:714-206-6095
Mailing Address - Fax:
Practice Address - Street 1:85448 MOLVENA DR
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92203-8300
Practice Address - Country:US
Practice Address - Phone:714-206-6095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA606712163WX0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0002XNursing Service ProvidersRegistered NurseObstetric, High-Risk