Provider Demographics
NPI:1295341055
Name:FISCHER, ALEXANDRA M (PA-C)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:M
Last Name:FISCHER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ALLIE
Other - Middle Name:
Other - Last Name:FISCHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6256 JUNEAU LN N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55311-4137
Mailing Address - Country:US
Mailing Address - Phone:763-464-1357
Mailing Address - Fax:
Practice Address - Street 1:6256 JUNEAU LN N
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55311-4137
Practice Address - Country:US
Practice Address - Phone:763-464-1357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-17
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant