Provider Demographics
NPI:1912218298
Name:FISHER, PATRICIA MARIE
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MARIE
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 1:969 UPHAM CT
Mailing Address - Street 2:#4
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214-4841
Mailing Address - Country:US
Mailing Address - Phone:720-628-5248
Mailing Address - Fax:
Practice Address - Street 1:1555 HUMBOLDT ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1614
Practice Address - Country:US
Practice Address - Phone:303-504-1600
Practice Address - Fax:303-831-5604
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO31090164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse