Kathleen L Fisher, RN, BC, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

086013 Issued in MO

Practice address

10012 Kennerly Rd
Suite 204
Saint Louis, MO 63128-2197

Phone

(314) 525-1220

Fax

(314) 842-9952

NPI assigned

Oct 12, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mercy Hospital South

  • Medicare Defined Swing Bed Hospital Unit
  • Saint Louis, MO
  • NPI 1033714209
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399939200000",
    "number": "1073501102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD",
            "address_2": "SUITE 204",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-525-1220",
            "fax_number": "314-842-9952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD",
            "address_2": "SUITE 204",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-525-1220",
            "fax_number": "314-842-9952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "KATHLEEN",
        "middle_name": "L",
        "credential": "RN, BC, ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2014-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "086013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "427628102",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fisher Dental Center
• Anya Lanka Fisher, LCSW
• Conrad Fisher
• David N Fisher, PA-C
• James Patrick Fisher, DDS
• Marsha Nicole Fisher, MD
• Maura Elaine Fisher, DPT
• Nathan M Fisher, D.O.
• Pangaa Fisher, FNP
• Rebecca Fisher

• All providers in Saint Louis, MO
• Adult Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.