Provider Demographics
NPI:1720256522
Name:FISHER, KATHERINE (APRN)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:FISHER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 ARDEN LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-2996
Mailing Address - Country:US
Mailing Address - Phone:803-980-7337
Mailing Address - Fax:803-980-2229
Practice Address - Street 1:724 ARDEN LN
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-2996
Practice Address - Country:US
Practice Address - Phone:803-980-7337
Practice Address - Fax:803-980-2229
Is Sole Proprietor?:No
Enumeration Date:2008-02-14
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1946392363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner