Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | RO43368 | MD |
NPI | 1033380225 |
---|---|
Provider Name | Mrs. Geraldine Hirsch Fitzgerald |
First Address | Garrett Park, MD 20896 |
Second Address | Garrett Park, MD 20896 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2008 |
Last Update Date | 17/03/2008 |