Individual
KATHLEEN MARY FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
944 BALDWIN RD, LAPEER, MI 48446-3089
(810) 245-5562
(810) 245-5562
Mailing address
3495 S CENTER RD, BURTON, MI 48519-1455
(810) 424-2007
(810) 743-1099
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704199786
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4706029
—
MI
01
—
5008705180
BCBSM INDIVIDUAL PIN
MI
Enumeration date
01/22/2007
Last updated
07/09/2007
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