Provider Demographics
NPI:1447971213
Name:FISHER DERMATOLOGY & AESTHETICS LLC
Entity type:Organization
Organization Name:FISHER DERMATOLOGY & AESTHETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAISY
Authorized Official - Middle Name:VIRGINIA
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:ANP-BC, FNP-BC
Authorized Official - Phone:201-926-0855
Mailing Address - Street 1:5454 WISCONSIN AVE STE 855
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-6948
Mailing Address - Country:US
Mailing Address - Phone:301-652-2585
Mailing Address - Fax:
Practice Address - Street 1:5454 WISCONSIN AVE STE 855
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-6948
Practice Address - Country:US
Practice Address - Phone:301-652-2585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty