Provider Demographics
NPI:1407085681
Name:FISHER, ANDREA LYNNE (OD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:LYNNE
Last Name:FISHER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38530 CHESTER RD
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-4047
Mailing Address - Country:US
Mailing Address - Phone:440-934-0055
Mailing Address - Fax:440-934-3055
Practice Address - Street 1:38530 CHESTER RD
Practice Address - Street 2:SUITE 300
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-4047
Practice Address - Country:US
Practice Address - Phone:440-934-0055
Practice Address - Fax:440-934-3055
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-08
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5861 T2775152WC0802X, 152WL0500X
OH5861152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation