Provider Demographics
NPI:1619981529
Name:FISCHER, JUNE M (RNP)
Entity Type:Individual
Prefix:MS
First Name:JUNE
Middle Name:M
Last Name:FISCHER
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 MIDDLEBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02879-7125
Mailing Address - Country:US
Mailing Address - Phone:401-284-3741
Mailing Address - Fax:
Practice Address - Street 1:595 EDDY STREET
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02901
Practice Address - Country:US
Practice Address - Phone:401-444-4000
Practice Address - Fax:401-444-8887
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINPP23217363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
509004041Medicare ID - Type Unspecified
S62887Medicare UPIN