Provider Demographics
NPI:1083292197
Name:FISHER-MCCLAIN, ALEXIS MARSHA
Entity Type:Individual
Prefix:MISS
First Name:ALEXIS
Middle Name:MARSHA
Last Name:FISHER-MCCLAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7717 W GOOD HOPE RD APT 316
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53223-4507
Mailing Address - Country:US
Mailing Address - Phone:414-248-0110
Mailing Address - Fax:
Practice Address - Street 1:7717 W GOOD HOPE RD APT 316
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-4507
Practice Address - Country:US
Practice Address - Phone:414-248-0110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator