MEDICARE: JENNIFER LEA FICHERA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant		NC

General Provider Information

NPI Number	:	1548009848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LEA FICHERA

Provider Business Mailing Address
First Line	:	5601 SPENCER FARM RD
Second Line	:
City	:	CLEMMONS
State	:	NC
Zip	:	27012-8347
Country	:	US
Telephone Number	:	734-660-2823
Fax Number	:

Provider Business Practice Location Address
First Line	:	3120 NORTHLINE AVE
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27408-7814
Country	:	US
Telephone Number	:	734-660-2823
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2024
Last Update Date	:	05/24/2024

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Directions to “ JENNIFER LEA FICHERA ” Practice Location

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