Sue Ellen Fisher, PHD, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

194725-4405 Issued in UT

Practice address

2994 Tolcate LN
Salt Lake City, UT 84121-1529

Phone

(801) 278-4598

NPI assigned

Dec 29, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Doctor of Philosophy

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.

• Valley Behavioral Health Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Valley City, UT
  • NPI 1932166980

  Psychiatric/Mental Health

  NPD (past)

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1568449619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2994 TOLCATE LN",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841211529",
            "telephone_number": "801-278-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2994 TOLCATE LN",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841211529",
            "telephone_number": "801-278-4598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "SUE",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "PHD, APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "UT",
            "license": "1947254405",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "194725-4405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTRMTN. HEALTH CARE",
            "identifier": "U006 107001404101",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DESERET MUTUAL",
            "identifier": "U002 262141",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDUCATORS MUTUAL",
            "identifier": "U003 942938348F11",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "U009 942938348",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Anne Fisher
• Miriam Fisher, MD
• Rachyl Marie Fisher
• Renee Christine Fisher, ACMHC
• Richard Fisher, D.M.D.
• Elizabeth Fisk, DPT
• Darby Alastar Fitchpatrick
• Kellie Fitke
• Amy Fitzgerald, MHS, RD, LD
• Betty Faun Fitzgerald

• Psychiatric/Mental Health Nurse Practitioner in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.