Provider Demographics
NPI:1023756335
Name:FISHER, KAYLA SHIANNE
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:SHIANNE
Last Name:FISHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3633 MUDDY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-2026
Mailing Address - Country:US
Mailing Address - Phone:513-543-0372
Mailing Address - Fax:
Practice Address - Street 1:3633 MUDDY CREEK RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-2026
Practice Address - Country:US
Practice Address - Phone:513-543-0372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care