Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 15323 | TN |
NPI | 1043520547 |
---|---|
Provider Name | Jennifer Marie Fitzsimmons |
First Address | Nashville, TN 37232-0001 |
Second Address | Nashville, TN 37232-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2010 |
Last Update Date | 15/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1524624 | (05) | TN |