Fisher, Shelly Dawn

Fisher, Shelly Dawn is an sole proprietor health care provider with primary practice located at 22 Bramhall St , Portland ME 04102-3175. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is her primary health care specialty. Fisher, Shelly Dawn can be contacted via phone (207) 662-0111.

Contact Information

Primary practice address
22 Bramhall St Portland ME 04102-3175
Phone: (207) 662-0111
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 103254 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 758279 New York
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RNA233008 Maine

Profile Details

NPI number 1912952839
LBN Legal business name Fisher, Shelly Dawn
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 23rd, 2006
Last updated Jul 17th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912952839 NPPES
Tennessee MEDICAID 3629385
Tennessee Other RNA233008
Tennessee Other 49727

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