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NPI Code Detail

MEDICARE: MRS. LISA ANN MARIE FISCHER FNP-BC

MEDICARE:  MRS. LISA ANN MARIE FISCHER  FNP-BC
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
1363LF0000XFamily Nurse Practitioner11000088FL

General Provider Information

NPI Number : 1972074383
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LISA ANN MARIE FISCHER FNP-BC
Provider Business Mailing Address
First Line : 972 EASTERWOOD CT SE
Second Line :
City : PALM BAY
State : FL
Zip : 32909-6835
Country : US
Telephone Number : 321-480-7611
Fax Number :
Provider Business Practice Location Address
First Line : 1250 S HARBOR CITY BLVD
Second Line :
City : MELBOURNE
State : FL
Zip : 32901-3242
Country : US
Telephone Number : 321-725-8919
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2018
Last Update Date : 12/10/2018

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Directions to “ MRS. LISA ANN MARIE FISCHER FNP-BC” Practice Location

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