Provider Demographics
NPI:1750702932
Name:FISCHER, LYNELLE JEAN (APNP)
Entity type:Individual
Prefix:
First Name:LYNELLE
Middle Name:JEAN
Last Name:FISCHER
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W146S7776 STAGS LEAP CT
Mailing Address - Street 2:
Mailing Address - City:MUSKEGO
Mailing Address - State:WI
Mailing Address - Zip Code:53150-7958
Mailing Address - Country:US
Mailing Address - Phone:414-651-1597
Mailing Address - Fax:
Practice Address - Street 1:8375 S HOWELL AVE
Practice Address - Street 2:
Practice Address - City:OAK CREEK
Practice Address - State:WI
Practice Address - Zip Code:53154-8344
Practice Address - Country:US
Practice Address - Phone:414-764-5726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-14
Last Update Date:2013-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5624-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily