Provider Demographics
NPI:1336284678
Name:FISHER, DONNA J (PTA)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:J
Last Name:FISHER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:J
Other - Last Name:BECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:245 N WESTHAVEN DR APT Y106
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54904-5492
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:855 N WESTHAVEN DR
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54904-7668
Practice Address - Country:US
Practice Address - Phone:920-456-7100
Practice Address - Fax:920-456-7123
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI361-019225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant