Provider Demographics
NPI:1609641059
Name:FISHER, SHAMONA
Entity Type:Individual
Prefix:
First Name:SHAMONA
Middle Name:
Last Name:FISHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7411 WILLOWCRAFT DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-3380
Mailing Address - Country:US
Mailing Address - Phone:832-687-2821
Mailing Address - Fax:
Practice Address - Street 1:7411 WILLOWCRAFT DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-3380
Practice Address - Country:US
Practice Address - Phone:832-687-2821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care