MEDICARE: KIMBERLY J FISHER NP

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	363LA2200X	Adult Health Nurse Practitioner	4051014	KY
2	363LA2200X	Adult Health Nurse Practitioner	71004172A	IN
3	363L00000X	Nurse Practitioner	71004172A	IN
4	363LA2200X	Adult Health Nurse Practitioner	226680	OK
5	363LA2200X	Adult Health Nurse Practitioner	2025034139	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649522269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY J FISHER NP

Provider Business Mailing Address
First Line	:	PO BOX 211699
Second Line	:
City	:	EAGAN
State	:	MN
Zip	:	55121-3699
Country	:	US
Telephone Number	:	866-849-0692
Fax Number	:	888-973-8821

Provider Business Practice Location Address
First Line	:	155 E MARKET ST FL 7
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46204-3294
Country	:	US
Telephone Number	:	866-849-0692
Fax Number	:	888-973-8821

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

Provider Enumeration Date	:	10/05/2012
Last Update Date	:	01/12/2026

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