Provider Demographics
NPI:1700422771
Name:FISCHER, EMILY ELIZABETH (FNP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ELIZABETH
Last Name:FISCHER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:E
Other - Last Name:BURESH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3518 LIVINGSTON LN
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-7709
Mailing Address - Country:US
Mailing Address - Phone:715-797-0386
Mailing Address - Fax:
Practice Address - Street 1:1125 BROADWAY ST N STE 3
Practice Address - Street 2:
Practice Address - City:MENOMONIE
Practice Address - State:WI
Practice Address - Zip Code:54751-1579
Practice Address - Country:US
Practice Address - Phone:920-496-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-25
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI976433363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner