Basic Information
| Provider Information | |||||||||
| NPI: | 1497375273 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FISHER | ||||||||
| FirstName: | PATRICIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1607 RACEHORSE CT | ||||||||
| Address2: | |||||||||
| City: | PARKTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283717716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5733378254 | ||||||||
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| Practice Location | |||||||||
| Address1: | 155 MEMORIAL DR | ||||||||
| Address2: | |||||||||
| City: | PINEHURST | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283748710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9107151000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/21/2020 | ||||||||
| LastUpdateDate: | 04/21/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 261893 | NC | Y | Nursing Service Providers | Registered Nurse |
No ID Information.