Healthcare Provider Details

I. General information

NPI: 1114842531
Provider Name (Legal Business Name): KARLY BRONWYN FISCHER DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

192 TILLEY DR
SOUTH BURLINGTON VT
05403-4440
US

IV. Provider business mailing address

192 TILLEY DR
SOUTH BURLINGTON VT
05403-4440
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-6000
  • Fax: 802-847-5819
Mailing address:
  • Phone: 802-847-6000
  • Fax: 802-847-5819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number101.0139708
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number101.0139708
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: