Provider Demographics
NPI:1629426879
Name:FICHERA, MARITA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:MARITA
Middle Name:
Last Name:FICHERA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 SPURWINK AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE ELIZABETH
Mailing Address - State:ME
Mailing Address - Zip Code:04107-9603
Mailing Address - Country:US
Mailing Address - Phone:207-767-2174
Mailing Address - Fax:
Practice Address - Street 1:155 SPURWINK AVE
Practice Address - Street 2:
Practice Address - City:CAPE ELIZABETH
Practice Address - State:ME
Practice Address - Zip Code:04107
Practice Address - Country:US
Practice Address - Phone:207-767-2174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-27
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP161182363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner