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General NPI Number Information
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NPI Number | 1942811088
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Entity Type | Individual
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Provider Name | JOHN CHRISTIAN FYFFE MSN, RN, FNP, RRT
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Gender | Male
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Dates
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Enumeration Date | 08/12/2020
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Last Update Date | 02/18/2024
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Provider Practice Location Address
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Address Line | 2100 MARKET ST
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City | CHARLESTOWN
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State | IN
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Zip | 47111-9535
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Country | US
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Telephone | 812-503-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 MARKET ST
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City | CHARLESTOWN
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State | IN
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Zip | 47111-9535
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Country | US
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Telephone | 812-503-5100
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 71010409A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 28231030A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 28231030A
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License Number State | IN
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