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General NPI Number Information
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NPI Number | 1386479301
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Entity Type | Individual
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Provider Name | STACEY FISCHER RDH
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Gender | Female
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Dates
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Enumeration Date | 09/09/2024
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 9225 DOERR RD
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City | FORT BELVOIR
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State | VA
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Zip | 22060-2204
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Country | US
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Telephone | 571-231-6005
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Fax |
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Provider Business Mailing Address
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Address Line | 8304 LINDSIDE WAY
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City | SPRINGFIELD
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State | VA
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Zip | 22153-3522
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Country | US
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Telephone | 513-520-6319
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State |
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