Provider Demographics
NPI:1851615298
Name:FISHER, SUSAN G (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:G
Last Name:FISHER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:NANCY
Other - Last Name:GREENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:1200 OLD YORK RD
Mailing Address - Street 2:4 LENFEST WEST
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3720
Mailing Address - Country:US
Mailing Address - Phone:215-481-4094
Mailing Address - Fax:215-481-8448
Practice Address - Street 1:1200 OLD YORK RD
Practice Address - Street 2:4 LENFEST WEST
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3720
Practice Address - Country:US
Practice Address - Phone:215-481-4094
Practice Address - Fax:215-481-8448
Is Sole Proprietor?:No
Enumeration Date:2010-03-14
Last Update Date:2010-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP008556363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics