Individual
MARISSA LEE FIDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
370 W HIGHLANDS DR STE 240, ELLIJAY, GA 30540-7745
(706) 635-1400
Mailing address
370 W HIGHLANDS DR STE 240, EAST ELLIJAY, GA 30540-7745
(706) 635-1400
(706) 635-1411
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13127
GA
Other
Enumeration date
07/31/2020
Last updated
08/08/2025
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