Provider Demographics
NPI:1760875942
Name:FISHER-KADOR, ERICA
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:FISHER-KADOR
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 1:3838 JOHN F KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39213-2407
Mailing Address - Country:US
Mailing Address - Phone:225-207-5137
Mailing Address - Fax:
Practice Address - Street 1:3838 JOHN F KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39213-2407
Practice Address - Country:US
Practice Address - Phone:225-207-5137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator