Healthcare Provider Details

I. General information

NPI: 1194682500
Provider Name (Legal Business Name): KATHERINE FISCHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 MILLER ST
QUINCY MA
02169-4725
US

IV. Provider business mailing address

54 MILLER ST
QUINCY MA
02169-4725
US

V. Phone/Fax

Practice location:
  • Phone: 617-847-1914
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number10013568
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: