Provider Demographics
NPI:1093438434
Name:FISCHER, KELLY MARIE (APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:MARIE
Last Name:FISCHER
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2791 STATE ROUTE 168
Mailing Address - Street 2:
Mailing Address - City:HOOKSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15050-1620
Mailing Address - Country:US
Mailing Address - Phone:412-916-1166
Mailing Address - Fax:
Practice Address - Street 1:651 COLLIERS WAY STE 313
Practice Address - Street 2:
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-5055
Practice Address - Country:US
Practice Address - Phone:304-140-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV84407207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine