Provider Demographics
NPI:1437010808
Name:FISHER, CHRYSTYNA (PRS)
Entity type:Individual
Prefix:
First Name:CHRYSTYNA
Middle Name:
Last Name:FISHER
Suffix:
Gender:F
Credentials:PRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2561 SHAW ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50317-7514
Mailing Address - Country:US
Mailing Address - Phone:515-642-7070
Mailing Address - Fax:
Practice Address - Street 1:706 CEDAR AVE
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:IA
Practice Address - Zip Code:50276-1010
Practice Address - Country:US
Practice Address - Phone:515-642-7070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-24
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAPR25021261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)