Provider Demographics
NPI:1417286600
Name:FISHER, CARRIE DAVIS (RRT)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:DAVIS
Last Name:FISHER
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7312 CARRINGTON OAKS LN
Mailing Address - Street 2:
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-1735
Mailing Address - Country:US
Mailing Address - Phone:813-727-1063
Mailing Address - Fax:
Practice Address - Street 1:7312 CARRINGTON OAKS LN
Practice Address - Street 2:
Practice Address - City:APOLLO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33572-1735
Practice Address - Country:US
Practice Address - Phone:813-727-1063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-17
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT9273227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered