Healthcare Provider Details

I. General information

NPI: 1093161119
Provider Name (Legal Business Name): R I FISCHER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2016
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 E US HIGHWAY 20
MICHIGAN CITY IN
46360-7424
US

IV. Provider business mailing address

555 WAGNER RD
PORTER IN
46304-1445
US

V. Phone/Fax

Practice location:
  • Phone: 219-872-7251
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71000760A
License Number StateIN

VIII. Authorized Official

Name: RACHEL IVA FISCHER
Title or Position: OWNER
Credential: NP
Phone: 219-928-1610