Provider Demographics
NPI:1831462100
Name:FISK, JANE NOEL (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:NOEL
Last Name:FISK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MISS
Other - First Name:JANE
Other - Middle Name:NOEL
Other - Last Name:BORSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3407 FREEMANSBURG AVE
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-5104
Mailing Address - Country:US
Mailing Address - Phone:610-252-2365
Mailing Address - Fax:
Practice Address - Street 1:701 OSTRUM ST
Practice Address - Street 2:SUITE 602
Practice Address - City:FOUNTAIN HILL
Practice Address - State:PA
Practice Address - Zip Code:18015-1155
Practice Address - Country:US
Practice Address - Phone:610-865-5888
Practice Address - Fax:610-865-1697
Is Sole Proprietor?:No
Enumeration Date:2012-02-17
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011791363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily