| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | Lane-Fisher, Theresa · THERESA LANE FISHER | [sources] | |||
| Birth date | not available | [sources] | |||
| Nationality | not available | [sources] | |||
| Country | United States | [sources] | |||
| First name | THERESA | [sources] | |||
| Last name | FISHER | [sources] | |||
| Middle name | LANE | [sources] | |||
| NPI | 1780898577 | [sources] | |||
| Sector | Physician Assistant | [sources] | |||
| Address | 4436 North State Street, Suite A1, Jackson, MS 39206 | [sources] | |||
| Last change | Last processed | First seen | |||
Service providers who have been terminated for cause from Mississippi's Medicaid program.
United States · Mississippi Division of Medicaid
Providers who have been terminated for cause from Georgia's Medicaid program.
United States · DCH
us-medms-01231575dcc7f74033e8278aec0e77f0150fb502 · us-medga-9c313d15a59719648a11709e2a0219ec4eebc5afFor experts: raw data explorer
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| United States | Georgia Department of Community Health | - | - |