Provider Demographics
NPI:1366938995
Name:FISCHER, ELIZABETH DAEDRIE (NP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:DAEDRIE
Last Name:FISCHER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 SAVANNAH RD
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1675
Mailing Address - Country:US
Mailing Address - Phone:302-645-3499
Mailing Address - Fax:
Practice Address - Street 1:17388 N VILLAGE MAIN BLVD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-7240
Practice Address - Country:US
Practice Address - Phone:302-291-6050
Practice Address - Fax:833-450-5311
Is Sole Proprietor?:No
Enumeration Date:2018-07-06
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5010651363LF0000X
DELG-0011537363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily