Provider Demographics
NPI:1013243203
Name:FISCHER, TANYA JO (RD)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:JO
Last Name:FISCHER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:TANYA
Other - Middle Name:JO
Other - Last Name:TORTORICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:CMR 445 BOX 599
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09046-0599
Mailing Address - Country:US
Mailing Address - Phone:0703-142-8663
Mailing Address - Fax:
Practice Address - Street 1:CMR 482
Practice Address - Street 2:STUTTGART HEALTH CLINIC ON PATCH BARRACKS
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09128
Practice Address - Country:US
Practice Address - Phone:0711680-430-4073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO873935133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered