Provider Demographics
NPI:1811694375
Name:FISHER, LATASHA RENEE
Entity type:Individual
Prefix:
First Name:LATASHA
Middle Name:RENEE
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 1:667 PARK LN APT P2
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-2208
Mailing Address - Country:US
Mailing Address - Phone:513-368-8864
Mailing Address - Fax:
Practice Address - Street 1:667 PARK LN APT P2
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-2208
Practice Address - Country:US
Practice Address - Phone:513-368-8864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health