Provider Demographics
NPI:1164199907
Name:FISCHER, EMILY N (NP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:N
Last Name:FISCHER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:N
Other - Last Name:GRESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 603725
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3725
Mailing Address - Country:US
Mailing Address - Phone:828-575-2625
Mailing Address - Fax:828-350-2174
Practice Address - Street 1:9002 N MERIDIAN ST STE 107
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5349
Practice Address - Country:US
Practice Address - Phone:317-848-9441
Practice Address - Fax:317-924-8239
Is Sole Proprietor?:No
Enumeration Date:2021-08-29
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71011490A363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ININ1125033OtherMEDICARE PTAN
IN300055003Medicaid
ININ1127030OtherMEDICARE PTAN