Provider Demographics
NPI:1750706636
Name:FISHER, LORI (RN)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:FISHER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W. STATE ST. SUITE A
Mailing Address - Street 2:FREMONT CITY SCHOOLS
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420
Mailing Address - Country:US
Mailing Address - Phone:419-665-2327
Mailing Address - Fax:419-665-2241
Practice Address - Street 1:500 W. STATE ST.
Practice Address - Street 2:SUITE A
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420
Practice Address - Country:US
Practice Address - Phone:419-665-2327
Practice Address - Fax:419-665-2241
Is Sole Proprietor?:No
Enumeration Date:2014-02-28
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 127546163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse