Individual
WILLIS FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
617 S RAYMOND ST, MARINETTE, WI 54143-1643
(715) 732-8855
Mailing address
617 S RAYMOND ST, MARINETTE, WI 54143-1643
(715) 732-8855
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
022491
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103339631
—
MI
01
—
430036342
MEDICARE RAILROAD
—
05
—
43335500
—
WI
Enumeration date
09/26/2006
Last updated
02/02/2023
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