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General NPI Number Information
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NPI Number | 1588905970
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Entity Type | Individual
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Provider Name | KELLY D FISCHER NP
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Gender | Female
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Dates
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Enumeration Date | 03/08/2013
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 633 EMERSON RD STE 100
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City | CREVE COEUR
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State | MO
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Zip | 63141-6739
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Country | US
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Telephone | 314-991-4335
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Fax |
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Provider Business Mailing Address
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Address Line | 560 QUEENS COURT PL
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City | SAINT PETERS
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State | MO
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Zip | 63376-7349
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Country | US
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Telephone | 314-348-8639
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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 | 2017007329
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License Number State | MO
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