Provider Demographics
NPI:1336490184
Name:FISCHER, CARRIE LEE (RN)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:LEE
Last Name:FISCHER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4192 TEALL BCH
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456-9277
Mailing Address - Country:US
Mailing Address - Phone:315-585-1001
Mailing Address - Fax:
Practice Address - Street 1:4192 TEALL BCH
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NY
Practice Address - Zip Code:14456-9277
Practice Address - Country:US
Practice Address - Phone:315-585-1001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY662281163W00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No163W00000XNursing Service ProvidersRegistered Nurse