Healthcare Provider Details

I. General information

NPI: 1598500860
Provider Name (Legal Business Name): MAGGIE ELIZABETH FISCHER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2024
Last Update Date: 06/28/2024
Certification Date: 06/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1506 S ONEIDA ST
APPLETON WI
54915-1305
US

IV. Provider business mailing address

835 S VAN BUREN ST
GREEN BAY WI
54301-3526
US

V. Phone/Fax

Practice location:
  • Phone: 920-831-8900
  • Fax:
Mailing address:
  • Phone: 920-884-3135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number15509-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: