Healthcare Provider Details

I. General information

NPI: 1447910559
Provider Name (Legal Business Name): PAMELA A FISCHER LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PAMELA A FISCHER OLESON LADC

II. Dates (important events)

Enumeration Date: 12/30/2021
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 9TH ST SE
ROCHESTER MN
55904
US

IV. Provider business mailing address

210 9TH ST SE
ROCHESTER MN
55904
US

V. Phone/Fax

Practice location:
  • Phone: 507-288-3443
  • Fax: 507-361-2404
Mailing address:
  • Phone: 507-288-3443
  • Fax: 507-361-2404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number306261
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: