Fisk, Connie

Fisk, Connie is an individual health care provider with primary practice located at 1 Commons St , Rutland VT 05701-4652. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Fisk, Connie can be contacted via phone (802) 747-1857.

Contact Information

Primary practice address
1 Commons St Rutland VT 05701-4652
Phone: (802) 747-1857
Fax: (802) 747-1026
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 101.0134648 Vermont
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X F401672 New York

Profile Details

NPI number 1508297599
LBN Legal business name Fisk, Connie
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 2nd, 2013
Last updated Oct 27th, 2020 - about 4 years ago

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 1508297599 NPPES
New York MEDICAID 03772176

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