Healthcare Provider Details

I. General information

NPI: 1114644192
Provider Name (Legal Business Name): CHRISTOPHER MICHAEL FICHERA APRN-CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: CHRIS FICHERA

II. Dates (important events)

Enumeration Date: 10/20/2022
Last Update Date: 06/08/2023
Certification Date: 06/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 LOMAS BLVD NE
ALBUQUERQUE NM
87106-2719
US

IV. Provider business mailing address

933 BRADBURY DR SE STE 2222
ALBUQUERQUE NM
87106-4375
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-2111
  • Fax:
Mailing address:
  • Phone: 505-272-3303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number70059
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: