MEDICARE: MARY A FISCHER 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	363LF0000X	Family Nurse Practitioner	0024165011	VA

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	:	1851475404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY A FISCHER NP

Provider Business Mailing Address
First Line	:	707 TERRACE AVE
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-4744
Country	:	US
Telephone Number	:	757-425-9277
Fax Number	:

Provider Business Practice Location Address
First Line	:	3143 MAGIC HOLLOW BLVD
Second Line	:	SUITE 200
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23453-3077
Country	:	US
Telephone Number	:	757-385-8222
Fax Number	:	757-368-3438

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

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	12/31/2013

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