Provider Demographics
NPI:1992394746
Name:FISHER, CARLA YVONNE (APN)
Entity Type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:YVONNE
Last Name:FISHER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PEBBLE BEACH DR
Mailing Address - Street 2:
Mailing Address - City:WESTAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-4726
Mailing Address - Country:US
Mailing Address - Phone:609-346-8875
Mailing Address - Fax:
Practice Address - Street 1:2 PEBBLE BEACH DR
Practice Address - Street 2:
Practice Address - City:WESTAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08060-4726
Practice Address - Country:US
Practice Address - Phone:609-346-8875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ011020000363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health