Provider Demographics
NPI:1740757137
Name:FICHTER, NINA RENEE
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:RENEE
Last Name:FICHTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARI
Other - Middle Name:BETH
Other - Last Name:TENNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2680 WAI WAI PL
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-8178
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2680 WAI WAI PL
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-8178
Practice Address - Country:US
Practice Address - Phone:808-545-2945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-24
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician