Mary Anne Fitzgerald
Nurse Practitioner - Women's Health
815 N Broadway Ave
Tyler
, Texas 75702-4507
Mary Anne Fitzgerald
Nurse Practitioner - Women's Health
815 N Broadway Ave
Tyler
, Texas 75702-4507
(903) 535-0052
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About
Features
Specialties
- Nurse Practitioner - Women's Health
Languages spoken
- English
Location
First Address
- Mary Anne Fitzgerald
- Po Box 2039
- Tyler, TX
- Zip : 75710-2039
- Fax : (903) 535-0052
- Phone : (903) 535-0023
Second Address
- Mary Anne Fitzgerald
- 815 N Broadway Ave
- Tyler, TX
- Zip : 75702-4507
- Fax : (903) 535-0052
- Phone : (903) 535-0023
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LW0102X | Nurse Practitioner - Women's Health | 218756 | TX |
National Provider Identifier
| NPI | 1013021757 |
|---|---|
| Provider Name | Mary Anne Fitzgerald |
| First Address | Tyler, TX 75710-2039 |
| Second Address | Tyler, TX 75702-4507 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/08/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 218756 | NURSE PRACTITIONER LICENS (01) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.