Provider Demographics
NPI:1487854477
Name:FISHER, MICHELLE RITA (APRN)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:RITA
Last Name:FISHER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DELAWARE STATE UNIVERSITY
Mailing Address - Street 2:1200 N. DUPONT HWY., ATTN - STUDENT HEALTH CTR
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901
Mailing Address - Country:US
Mailing Address - Phone:302-857-6393
Mailing Address - Fax:302-857-7676
Practice Address - Street 1:DELAWARE STATE UNIVERSITY
Practice Address - Street 2:1200 N. DUPONT HWY., ATTN - STUDENT HEALTH CTR
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901
Practice Address - Country:US
Practice Address - Phone:302-857-6393
Practice Address - Fax:302-857-7676
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL6-0000174363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner