Provider Demographics
NPI:1730842246
Name:FISCHER, KIMBERLY ANN BREUNIG (PA-C, MPH)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ANN BREUNIG
Last Name:FISCHER
Suffix:
Gender:F
Credentials:PA-C, MPH
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:ANN
Other - Last Name:BRUENIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C, MPH
Mailing Address - Street 1:201 GRAND CANYON DR APT 4
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-4259
Mailing Address - Country:US
Mailing Address - Phone:608-212-1592
Mailing Address - Fax:
Practice Address - Street 1:201 GRAND CANYON DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-4259
Practice Address - Country:US
Practice Address - Phone:608-212-1592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-21
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI549523363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant