Basic Information
| Provider Information | |||||||||
| NPI: | 1568554921 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FISHER | ||||||||
| FirstName: | REBECCA | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | PA C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 60 COMMERCIAL ST | ||||||||
| Address2: | SUITE 401 | ||||||||
| City: | CONCORD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 033015071 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6032287555 | ||||||||
| FaxNumber: | 6032287558 | ||||||||
| Practice Location | |||||||||
| Address1: | 60 COMMERCIAL ST | ||||||||
| Address2: | SUITE 401 | ||||||||
| City: | CONCORD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 033015071 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6032287555 | ||||||||
| FaxNumber: | 6032287558 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/29/2006 | ||||||||
| LastUpdateDate: | 10/04/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | PA760 | ME | N | Allopathic & Osteopathic Physicians | Family Medicine | 363AM0700X | 400 | NH | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.