Fitzgerald, Kimberly Ann

Fitzgerald, Kimberly Ann is an individual health care provider with primary practice located at 845 S Main St Ste 120 , Fond Du Lac WI 54935-6116. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Fitzgerald, Kimberly Ann can be contacted via phone (920) 322-0447.

Contact Information

Primary practice address
845 S Main St Ste 120 Fond Du Lac WI 54935-6116
Phone: (920) 322-0447
Fax: (920) 322-1362
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 4507-026 Wisconsin

Profile Details

NPI number 1972717460
LBN Legal business name Fitzgerald, Kimberly Ann
Credentials Registered Occupational Therapist (OTR)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2007
Last updated May 9th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972717460 NPPES
Wisconsin MEDICAID 41043800

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