Individual
MARISSA FISCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
419 S CORAL ST, KALKASKA, MI 49646-2503
(231) 258-7500
Mailing address
PO BOX 916, TRAVERSE CITY, MI 49685-0916
(231) 258-7506
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601008962
MI
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5315203825
PHARMACY (CS-2)
MI
01
—
5601008962
LICENSE NUMBER
MI
Enumeration date
01/17/2019
Last updated
11/25/2022
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