Healthcare Provider Details

I. General information

NPI: 1104722149
Provider Name (Legal Business Name): NM ADVANCED PRACTICE HEALTHCARE GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2026
Last Update Date: 11/07/2026
Certification Date: 11/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2305 CORTINA LOOP SE
RIO RANCHO NM
87124
US

IV. Provider business mailing address

1209 MOUNTAIN ROAD PL NE STE R
ALBUQUERQUE NM
87110-7825
US

V. Phone/Fax

Practice location:
  • Phone: 505-977-9174
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER FICHERA
Title or Position: MANAGER/SOLE MEMBER
Credential: AG-ACNP
Phone: 505-977-9174