National Provider Identifier Database

ALLYCE K FISK, PA-C – NPI #1730432709
Surgical


Contact Information

ALLYCE K FISK, PA-C
215 RADIO DR STE 100
WOODBURY, MN55125-5817
Phone: 612-596-6100
Fax:
Website:
Specialty Taxonomy Code
* Surgical 363AS0400X
Physician Assistant 363A00000X

* Indicates primary specialty

NPI Profile & details for ALLYCE K FISK

NPI Number 1730432709
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 10/16/2012
Last updated 02/15/2021 - About 5 years ago
Sole proprietor1 No
Identifiers
  • MN License #: 11228
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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