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Individual
CANDY SUE FISCHBACH
Active
Individual
CANDY SUE FISCHBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA369
KY
363AM0700X
Medical Physician Assistant
PA 369
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000246341
ANTHEM
KY
Enumeration date
07/11/2005
Last updated
04/03/2015
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