Healthcare Provider Details

I. General information

NPI: 1396316139
Provider Name (Legal Business Name): ELYSE ANDERBERY FICHTHORN RN, BSN, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2021
Last Update Date: 11/02/2025
Certification Date: 11/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 N MAIN ST
AKRON OH
44310-3110
US

IV. Provider business mailing address

444 N MAIN ST
AKRON OH
44310-3110
US

V. Phone/Fax

Practice location:
  • Phone: 330-762-2273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.441261
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN.CRNA.0020373
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: