Provider Demographics
NPI:1528762929
Name:FISHER, SARA R (RN)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:R
Last Name:FISHER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:R
Other - Last Name:VANCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3931 HARFORD RD
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18834-6765
Mailing Address - Country:US
Mailing Address - Phone:570-766-5254
Mailing Address - Fax:
Practice Address - Street 1:3931 HARFORD RD
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:PA
Practice Address - Zip Code:18834-6765
Practice Address - Country:US
Practice Address - Phone:570-766-5254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY752978163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse