Provider Demographics
NPI:1396304911
Name:FISCHER, ALICIA C (APRN)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:C
Last Name:FISCHER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3755
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68103-0755
Mailing Address - Country:US
Mailing Address - Phone:402-354-2100
Mailing Address - Fax:402-354-4230
Practice Address - Street 1:5908 S 142ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-2800
Practice Address - Country:US
Practice Address - Phone:402-354-1001
Practice Address - Fax:402-354-1910
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE112796363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1396304911Medicaid
NE47068731749Medicaid
NE47068731741Medicaid
NE10026480100Medicaid
NE47068731734Medicaid