Healthcare Provider Details

I. General information

NPI: 1497822878
Provider Name (Legal Business Name): BONNIE K FISCHER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 OCHRE POINT AVE
NEWPORT RI
02840-4149
US

IV. Provider business mailing address

8 LINDEN GATE LN
NEWPORT RI
02840-3335
US

V. Phone/Fax

Practice location:
  • Phone: 401-341-2904
  • Fax: 401-341-2934
Mailing address:
  • Phone: 401-847-3040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberNPP21319
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: