1326128059 NPI number — LAURA G FISHER CRNA

Table of content: LAURA G FISHER CRNA (NPI 1326128059)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326128059 NPI number — LAURA G FISHER CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FISHER
Provider First Name:
LAURA
Provider Middle Name:
G
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326128059
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/10/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 932840
Provider Second Line Business Mailing Address:
WINDY HILL ANESTHESIA ASSOCIATES PC
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31193-2840
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-749-2940
Provider Business Mailing Address Fax Number:
706-660-9390

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2540 WINDY HILL ROAD
Provider Second Line Business Practice Location Address:
WINDY HILL HOSPITAL
Provider Business Practice Location Address City Name:
MARIETTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30067
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-644-1000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/17/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  RN076869 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000632849AC , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 322902 . This is a "WELLCARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: GRP757 . This is a "MEDICARE GROUP" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".