Provider Demographics
NPI:1295047504
Name:FISCHER, KAREN M (ACNS-BC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:FISCHER
Suffix:
Gender:F
Credentials:ACNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5514 CORPORATE DR STE 150
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64507-7763
Mailing Address - Country:US
Mailing Address - Phone:816-271-1241
Mailing Address - Fax:816-279-7794
Practice Address - Street 1:5514 CORPORATE DR.
Practice Address - Street 2:STE. 150
Practice Address - City:ST JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64507-7752
Practice Address - Country:US
Practice Address - Phone:816-271-1221
Practice Address - Fax:816-279-7794
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-02
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO095059364SA2200X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1295047504Medicaid
KS200671020AMedicaid
MO701000064Medicare PIN