Healthcare Provider Details

I. General information

NPI: 1124534235
Provider Name (Legal Business Name): CAROLINE FICHTER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROLINE FICHTER NP

II. Dates (important events)

Enumeration Date: 12/27/2017
Last Update Date: 01/20/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 WISCONSIN AVE STE 2
WHITEFISH MT
59937-2319
US

IV. Provider business mailing address

PO BOX 1951
WHITEFISH MT
59937-1951
US

V. Phone/Fax

Practice location:
  • Phone: 301-641-4056
  • Fax:
Mailing address:
  • Phone: 301-641-4056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number128518
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number128518
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: