Provider Demographics
NPI:1295054252
Name:FISHER, ANNA RACHELLE (DC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:RACHELLE
Last Name:FISHER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:RACHELLE
Other - Last Name:ZEDIKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1125 PIERCE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51105-1485
Mailing Address - Country:US
Mailing Address - Phone:712-258-9044
Mailing Address - Fax:712-258-9043
Practice Address - Street 1:1125 PIERCE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51105-1485
Practice Address - Country:US
Practice Address - Phone:712-258-9044
Practice Address - Fax:712-258-9043
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007255111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA202250002Medicare PIN