Fisher, Sue Ellen

Fisher, Sue Ellen is an sole proprietor health care provider with primary practice located at 2994 Tolcate Ln , Salt Lake City UT 84121-1529. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Psychiatric/Mental Health, Adult, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Fisher, Sue Ellen can be contacted via phone (801) 278-4598.

Contact Information

Primary practice address
2994 Tolcate Ln Salt Lake City UT 84121-1529
Phone: (801) 278-4598
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Psychiatric/Mental Health, Adult 163WP0809X 1947254405 Utah
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 194725-4405 Utah

Profile Details

NPI number 1568449619
LBN Legal business name Fisher, Sue Ellen
Credentials PHD, APRN
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 29th, 2005
Last updated Mar 7th, 2023 - about 3 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 1568449619 NPPES
Utah Other U006 107001404101 INTRMTN. HEALTH CARE
Utah Other U002 262141 INTRMTN. HEALTH CARE
Utah Other U003 942938348F11 INTRMTN. HEALTH CARE
Utah Other U009 942938348 INTRMTN. HEALTH CARE

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