Provider Demographics
NPI:1407181050
Name:FISHER, PATRICIA LANE (ANP-BC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LANE
Last Name:FISHER
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6455 S YOSEMITE ST STE 600
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-5143
Mailing Address - Country:US
Mailing Address - Phone:720-641-0233
Mailing Address - Fax:855-257-8295
Practice Address - Street 1:6455 S YOSEMITE ST STE 600
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-5143
Practice Address - Country:US
Practice Address - Phone:720-641-0233
Practice Address - Fax:855-257-8295
Is Sole Proprietor?:No
Enumeration Date:2009-10-14
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO181473363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology