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NPI Code Detail

MEDICARE: JENNIFER E. MONTGOMERY FISCHER MD

MEDICARE: JENNIFER E. MONTGOMERY FISCHER MD
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
12084P0804XChild & Adolescent Psychiatry Physician60439-20WI

General Provider Information

NPI Number : 1356502561
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER E. MONTGOMERY FISCHER MD
Provider Business Mailing Address
First Line : 3860 MONROE RD
Second Line :
City : DE PERE
State : WI
Zip : 54115-8399
Country : US
Telephone Number : 920-496-4700
Fax Number :
Provider Business Practice Location Address
First Line : 2680 VERNON DR
Second Line :
City : GREEN BAY
State : WI
Zip : 54304-5374
Country : US
Telephone Number : 920-496-4700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2008
Last Update Date : 06/12/2018

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