Provider Demographics
NPI:1720077597
Name:FISCHER, BERNARD RAYMOND (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:BERNARD
Middle Name:RAYMOND
Last Name:FISCHER
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9441 CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-6414
Mailing Address - Country:US
Mailing Address - Phone:701-221-2059
Mailing Address - Fax:
Practice Address - Street 1:9441 CEDAR LN
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-6414
Practice Address - Country:US
Practice Address - Phone:701-221-2059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR19714363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
R02164Medicare UPIN