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Contact Information

ALLYCE K FISK, PA-C
215 RADIO DR STE 100
WOODBURY, MN55125-5817
 Phone: 612-596-6100
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical

363AS0400X 97 Physician Assistant
 

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for ALLYCE K FISK · (Female)

NPI Number 1730432709
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 10/16/2012
Last updated 02/15/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • MN License # 11228
Hospital affiliation(s) Not Available
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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