Provider Demographics
NPI:1447643986
Name:FICHTER, JESSICA KATHLEEN (CRNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:KATHLEEN
Last Name:FICHTER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:297 MCKEE RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-7755
Mailing Address - Country:US
Mailing Address - Phone:724-986-9247
Mailing Address - Fax:
Practice Address - Street 1:9 CAMPBELL DR
Practice Address - Street 2:
Practice Address - City:AVELLA
Practice Address - State:PA
Practice Address - Zip Code:15312-2738
Practice Address - Country:US
Practice Address - Phone:724-587-3472
Practice Address - Fax:724-587-5947
Is Sole Proprietor?:No
Enumeration Date:2015-03-09
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3016066363LF0000X, 363LP2300X
PASP014848363LF0000X
WVAPRN82807363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care