Healthcare Provider Details

I. General information

NPI: 1487876595
Provider Name (Legal Business Name): MONIKA INSLEE FISCHER ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 E BROADWAY SUITE 200
GLENDALE CA
91205-4927
US

IV. Provider business mailing address

2317 MIRA VISTA AVE UNIT G
MONTROSE CA
91020-1889
US

V. Phone/Fax

Practice location:
  • Phone: 818-548-6488
  • Fax:
Mailing address:
  • Phone: 818-248-8830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License Number379829
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: