Provider Demographics
NPI:1700930666
Name:FISHER, MARGARET A (RN, FNP)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:A
Last Name:FISHER
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:NY
Mailing Address - Zip Code:13790-2120
Mailing Address - Country:US
Mailing Address - Phone:607-729-4942
Mailing Address - Fax:607-729-7516
Practice Address - Street 1:1000 E GENESEE ST
Practice Address - Street 2:SUITE 602
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1892
Practice Address - Country:US
Practice Address - Phone:315-475-3999
Practice Address - Fax:315-475-0414
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF333221363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02739191Medicaid