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Individual

LORAINE A FISHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
3740 EDISON LAKES PKWY, MISHAWAKA, IN 46545-3448
(574) 252-4150
Mailing address
3740 EDISON LAKES PKWY, MISHAWAKA, IN 46545-3448
(574) 252-4150

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71003921A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201067440
IN
01
28081328A
RN LICENSE
IN
01
4704352599
APRN LICENSE
MI
01
71003921A
APRN LICENSE
IN
Enumeration date
12/21/2011
Last updated
03/07/2023
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