Provider Demographics
NPI:1588830103
Name:FISHER, HARVEY (RN)
Entity Type:Individual
Prefix:MR
First Name:HARVEY
Middle Name:
Last Name:FISHER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 KELLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80109-7974
Mailing Address - Country:US
Mailing Address - Phone:303-660-0514
Mailing Address - Fax:
Practice Address - Street 1:4201 KELLWOOD DR
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80109-7974
Practice Address - Country:US
Practice Address - Phone:303-660-0514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-03
Last Update Date:2008-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO113867163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology