Provider Demographics
NPI:1578709135
Name:FISHER, LYNITA TERESA (BS AND MED)
Entity Type:Individual
Prefix:MRS
First Name:LYNITA
Middle Name:TERESA
Last Name:FISHER
Suffix:
Gender:F
Credentials:BS AND MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1244 SERENADE LANE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75241
Mailing Address - Country:US
Mailing Address - Phone:214-376-0533
Mailing Address - Fax:214-376-6649
Practice Address - Street 1:1244 SERENADE LANE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75241
Practice Address - Country:US
Practice Address - Phone:214-376-0533
Practice Address - Fax:214-376-6649
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-31
Last Update Date:2009-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX226404163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse