Individual
MRS. GRETCHEN BOENKE FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
130 W RAVINE RD, KINGSPORT, TN 37660-3837
(423) 224-4000
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/07/2024
Last updated
06/07/2024
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