Healthcare Provider Details

I. General information

NPI: 1003726019
Provider Name (Legal Business Name): HAYLEY FISCHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 FEDERAL DR
FORT SNELLING MN
55111-4080
US

IV. Provider business mailing address

4184 HALLGREN LN
EXCELSIOR MN
55331-7770
US

V. Phone/Fax

Practice location:
  • Phone: 918-295-3000
  • Fax:
Mailing address:
  • Phone: 952-221-2598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number14758
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: