Provider Demographics
NPI:1821190539
Name:FISHER, LATRONICA TARSUNET (ARNP, NP)
Entity Type:Individual
Prefix:MRS
First Name:LATRONICA
Middle Name:TARSUNET
Last Name:FISHER
Suffix:
Gender:F
Credentials:ARNP, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 FM 1960 RD
Mailing Address - Street 2:STE #101
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77073-1886
Mailing Address - Country:US
Mailing Address - Phone:281-443-8226
Mailing Address - Fax:281-443-8157
Practice Address - Street 1:324 FM 1960 RD
Practice Address - Street 2:STE #101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77073-1886
Practice Address - Country:US
Practice Address - Phone:281-443-8226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2013-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67905363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2858011Medicaid
TX2858011Medicaid
128963Medicare UPIN