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General NPI Number Information
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NPI Number | 1346892312
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Entity Type | Individual
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Provider Name | SAMANTHA ANN FISER APNP
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Gender | Female
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Dates
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Enumeration Date | 07/10/2019
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 510 ACKLEY ST STE 2
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City | ANTIGO
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State | WI
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Zip | 54409-2402
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Country | US
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Telephone | 715-500-4651
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Fax | 715-350-4179
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Provider Business Mailing Address
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Address Line | 15954 RIVERS EDGE DR
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City | HAYWARD
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State | WI
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Zip | 54843-7800
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Country | US
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Telephone | 715-634-2541
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9330
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 9330
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License Number State | WI
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