Provider Demographics
NPI:1831914456
Name:FISCHER, RODGER
Entity type:Individual
Prefix:MR
First Name:RODGER
Middle Name:
Last Name:FISCHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4107 VINE ST
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-9482
Mailing Address - Country:US
Mailing Address - Phone:785-625-3550
Mailing Address - Fax:316-469-0806
Practice Address - Street 1:4107 VINE ST
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-9482
Practice Address - Country:US
Practice Address - Phone:785-625-3550
Practice Address - Fax:316-469-0806
Is Sole Proprietor?:No
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS23-34381-021164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse