Healthcare Provider Details

I. General information

NPI: 1760347033
Provider Name (Legal Business Name): ANNIKA FISHER APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 LILAC DR N STE 140
GOLDEN VALLEY MN
55422-4791
US

IV. Provider business mailing address

820 LILAC DR N STE 140
GOLDEN VALLEY MN
55422-4791
US

V. Phone/Fax

Practice location:
  • Phone: 763-465-0500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number13460
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: