Individual
DR. HEATHER ANNE FISANICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1303 SHOEMAKER ST, NANTY GLO, PA 15943-1254
(814) 749-7872
Mailing address
108 MURPHY SPRING RD, HASTINGS, PA 16646-6904
(814) 937-5566
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP046224L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RP046224L
STATE LICENSE
PA
Enumeration date
07/10/2020
Last updated
07/10/2020
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