Provider Demographics
NPI:1033315213
Name:FITCH, JEAN HERSHEY (ARNP)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:HERSHEY
Last Name:FITCH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:HELEN
Other - Last Name:HERSHEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:9240853ARNP
Mailing Address - Street 1:9246 ESTERO RIVER CIR
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-4417
Mailing Address - Country:US
Mailing Address - Phone:239-470-8011
Mailing Address - Fax:239-590-7968
Practice Address - Street 1:FLORIDA GULF COAST UNIVERSITY STUDENT HEALTH SERVICES
Practice Address - Street 2:10501 FGCU BOULEVARD SOUTH
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33965-6565
Practice Address - Country:US
Practice Address - Phone:239-590-7966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9240853363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner