Provider Demographics
NPI:1477340727
Name:FISHER, KATEY NICOLE (MS, CCC/SLP)
Entity type:Individual
Prefix:
First Name:KATEY
Middle Name:NICOLE
Last Name:FISHER
Suffix:
Gender:
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11835 ORCHARD LN
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:PA
Mailing Address - Zip Code:17268-9275
Mailing Address - Country:US
Mailing Address - Phone:724-322-9833
Mailing Address - Fax:
Practice Address - Street 1:2055 SCOTLAND AVE
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-1451
Practice Address - Country:US
Practice Address - Phone:717-217-2097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL012300235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
14044542OtherASHA
SL012300OtherPA LICENSURE