Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 26NN09993200 | NJ |
Y | 363LA2200X | Nurse Practitioner - Adult Health | 218717 | LA |
NPI | 1013129311 |
---|---|
Provider Name | Mrs. Jennifer Dehm Fitzgibbons |
First Address | New Orleans, LA 70112-2632 |
Second Address | New Orleans, LA 70112-2632 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 18/01/2022 |