MEDICARE: ALLYSON FISCHER FNP

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	363LF0000X	Family Nurse Practitioner	2024033800	MO

General Provider Information

NPI Number	:	1669262564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLYSON FISCHER FNP

Provider Business Mailing Address
First Line	:	533 PFEFFER DR
Second Line	:
City	:	COLUMBIA
State	:	IL
Zip	:	62236-2749
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10012 KENNERLY RD STE 300
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63128-2197
Country	:	US
Telephone Number	:	314-842-0602
Fax Number	:

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

Provider Enumeration Date	:	05/12/2025
Last Update Date	:	06/03/2026

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