Provider Demographics
NPI:1114901766
Name:FISCHER, DONETA M (APRN)
Entity Type:Individual
Prefix:
First Name:DONETA
Middle Name:M
Last Name:FISCHER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5046
Mailing Address - Country:US
Mailing Address - Phone:603-228-1111
Mailing Address - Fax:603-226-4314
Practice Address - Street 1:189 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5046
Practice Address - Country:US
Practice Address - Phone:603-228-1111
Practice Address - Fax:603-226-4314
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH02528623363LX0001X
NH025286-23363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30008621Medicaid
NP0963Medicare PIN
S51135Medicare UPIN
FINP0963Medicare ID - Type Unspecified