Provider Demographics
NPI:1497815153
Name:FISCHER, JULIE ANN (PCA)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:FISCHER
Suffix:
Gender:F
Credentials:PCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:BOX 175
Mailing Address - Street 2:780 1ST ST E
Mailing Address - City:LAKE LILLIAN
Mailing Address - State:MN
Mailing Address - Zip Code:56753
Mailing Address - Country:US
Mailing Address - Phone:320-235-4613
Mailing Address - Fax:320-231-9140
Practice Address - Street 1:1125 6TH STREET SE
Practice Address - Street 2:WOODLAND CENTERS
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-4675
Practice Address - Country:US
Practice Address - Phone:320-231-9148
Practice Address - Fax:320-231-9140
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant