Fitzgerald, Mary Anne
Fitzgerald, Mary Anne is an individual health care provider with primary practice located at 815 N Broadway Ave , Tyler TX 75702-4507. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Women's Health, which is considered as her primary health care specialty. Fitzgerald, Mary Anne can be contacted via phone (903) 535-0023.Contact Information
Primary practice address
815 N Broadway Ave
Tyler TX 75702-4507
Phone: (903) 535-0023
Fax: (903) 535-0052
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Women's Health | 363LW0102X | 218756 | Texas |
Profile Details
| NPI number | 1013021757 |
|---|---|
| LBN Legal business name | Fitzgerald, Mary Anne |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 19th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013021757 | NPPES |
| Texas | Other | 218756 | NURSE PRACTITIONER LICENS |
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