Healthcare Provider Details

I. General information

NPI: 1427215581
Provider Name (Legal Business Name): LAYNE K FISCHER OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2008
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 CHICAGO ST
DE PERE WI
54115-3418
US

IV. Provider business mailing address

4097 GEMSTONE TRL
GREEN BAY WI
54311-9009
US

V. Phone/Fax

Practice location:
  • Phone: 920-337-1032
  • Fax:
Mailing address:
  • Phone: 608-780-4319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number4622026
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: