Healthcare Provider Details

I. General information

NPI: 1336812601
Provider Name (Legal Business Name): MRS. ANGELA CHRISTINE FICHTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2021
Last Update Date: 07/31/2021
Certification Date: 07/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 SOUTH ST
GRETNA NE
68028-7865
US

IV. Provider business mailing address

801 SOUTH ST
GRETNA NE
68028-7865
US

V. Phone/Fax

Practice location:
  • Phone: 402-332-3341
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number75933
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: