MEDICARE: ROXINA FISCHER FNP-C

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	363L00000X	Nurse Practitioner	215935-4405	UT

General Provider Information

NPI Number	:	1932197084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROXINA FISCHER FNP-C

Provider Business Mailing Address
First Line	:	PO BOX 5546
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80217-5546
Country	:	US
Telephone Number	:	801-475-3800
Fax Number	:	801-475-3801

Provider Business Practice Location Address
First Line	:	6112 S 1550 E
Second Line	:
City	:	SOUTH OGDEN
State	:	UT
Zip	:	84405-5007
Country	:	US
Telephone Number	:	801-475-3800
Fax Number	:	801-475-3801

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

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	01/17/2017

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Directions to “ ROXINA FISCHER FNP-C” Practice Location

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