Individual
AUDREY ANN FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
100 E LEHIGH AVE, CHC-2, PHILA, PA 19125-1012
(215) 707-1840
(215) 707-8570
Mailing address
100 E LEHIGH AVE, CHC-2, PHILA, PA 19125-1012
(215) 707-1840
(215) 707-8570
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA00125L
PA
363A00000X
Physician Assistant
OA000233L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
597586
MEDICARE GROUP
PA
01
—
CD4829
RAILROADMEDICARE
PA
Enumeration date
12/15/2005
Last updated
05/04/2011
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