MEDICARE: SHERI MONIQUE FISCHER RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	2083520	MN

General Provider Information

NPI Number	:	1043721525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERI MONIQUE FISCHER RN

Provider Business Mailing Address
First Line	:	2060 CENTRE POINTE BLVD STE 3
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55120-1271
Country	:	US
Telephone Number	:	651-774-0011
Fax Number	:

Provider Business Practice Location Address
First Line	:	4691 234TH CT NW
Second Line	:
City	:	SAINT FRANCIS
State	:	MN
Zip	:	55070-9370
Country	:	US
Telephone Number	:	612-385-3491
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2017
Last Update Date	:	10/23/2017

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