Provider Demographics
NPI:1033308986
Name:FISCHER, SUSAN LYNCH (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:LYNCH
Last Name:FISCHER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 S CONGRESS AVE # B
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-6543
Mailing Address - Country:US
Mailing Address - Phone:561-276-8444
Mailing Address - Fax:
Practice Address - Street 1:1601 S CONGRESS AVE # B
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-6543
Practice Address - Country:US
Practice Address - Phone:561-276-8444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL763192363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL302791100Medicaid