MEDICARE: STACEY ANN FISCHER

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	374U00000X	Home Health Aide
2	372600000X	Adult Companion
3	376J00000X	Homemaker	OH

General Provider Information

NPI Number	:	1407534431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACEY ANN FISCHER

Provider Business Mailing Address
First Line	:	2653 MCKINLEY AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-7207
Country	:	US
Telephone Number	:	513-501-4101
Fax Number	:

Provider Business Practice Location Address
First Line	:	2653 MCKINLEY AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-7207
Country	:	US
Telephone Number	:	513-501-4101
Fax Number	:

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

Provider Enumeration Date	:	07/10/2023
Last Update Date	:	07/10/2023

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Directions to “ STACEY ANN FISCHER ” Practice Location

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