Provider Demographics
NPI:1972890044
Name:FISHER, TERRI ANNETTE (FPMHNP)
Entity Type:Individual
Prefix:MS
First Name:TERRI
Middle Name:ANNETTE
Last Name:FISHER
Suffix:
Gender:F
Credentials:FPMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 HART STREET
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SHEPPARD AFB
Mailing Address - State:TX
Mailing Address - Zip Code:76311-3492
Mailing Address - Country:US
Mailing Address - Phone:940-676-6075
Mailing Address - Fax:
Practice Address - Street 1:149 HART STREET
Practice Address - Street 2:SUITE 5
Practice Address - City:SHEPPARD AFB
Practice Address - State:TX
Practice Address - Zip Code:76311-3492
Practice Address - Country:US
Practice Address - Phone:940-676-6075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-08
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX626121363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health