Basic Information
| Provider Information | |||||||||
| NPI: | 1508127655 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FISHER | ||||||||
| FirstName: | KIMBERLY | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O., M.B.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 421 CHESTNUT ST | ||||||||
| Address2: | |||||||||
| City: | EVANSVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 477131227 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8124269311 | ||||||||
| FaxNumber: | 8124269839 | ||||||||
| Practice Location | |||||||||
| Address1: | 421 CHESTNUT ST | ||||||||
| Address2: | |||||||||
| City: | EVANSVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 47713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8124269311 | ||||||||
| FaxNumber: | 8124269839 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2012 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | 20A15565 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 207RR0500X | 02005859A | IN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
No ID Information.