Basic Information
| Provider Information | |||||||||
| NPI: | 1558789412 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FITZGERALD | ||||||||
| FirstName: | ANN MARIE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | CFNP, MSN, RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 101 WILSON RD | ||||||||
| Address2: | SUITE C | ||||||||
| City: | MONTEREY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939407834 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8316499200 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 23625 WR HOLMAN HWY | ||||||||
| Address2: | |||||||||
| City: | MONTEREY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939405902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8316245311 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2014 | ||||||||
| LastUpdateDate: | 06/30/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 14608 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.