Healthcare Provider Details

I. General information

NPI: 1255390142
Provider Name (Legal Business Name): KIMBERLY A FISCHER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1875 WOODWINDS DR STE 100
WOODBURY MN
55125-2501
US

IV. Provider business mailing address

PO BOX 81068
CLEVELAND OH
44181-0068
US

V. Phone/Fax

Practice location:
  • Phone: 651-770-3320
  • Fax:
Mailing address:
  • Phone: 561-322-4171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number43540
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: