Provider Demographics
NPI:1821376112
Name:FISHER, AMBER YVONNE (CNA)
Entity Type:Individual
Prefix:MISS
First Name:AMBER
Middle Name:YVONNE
Last Name:FISHER
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9014 STATE ROUTE 3 WEST
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45113
Mailing Address - Country:US
Mailing Address - Phone:937-728-3727
Mailing Address - Fax:
Practice Address - Street 1:9014 US HIGHWAY 3 W
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:45113
Practice Address - Country:US
Practice Address - Phone:937-728-3727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide