Provider Demographics
NPI:1033380225
Name:FITZGERALD, GERALDINE HIRSCH (RN, CPNP, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:GERALDINE
Middle Name:HIRSCH
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:RN, CPNP, IBCLC
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Mailing Address - Street 1:PO BOX 67
Mailing Address - Street 2:10709 MONTROSE AVE
Mailing Address - City:GARRETT PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20896
Mailing Address - Country:US
Mailing Address - Phone:301-946-4532
Mailing Address - Fax:301-946-2448
Practice Address - Street 1:10709 MONTROSE AVE
Practice Address - Street 2:#67
Practice Address - City:GARRETT PARK
Practice Address - State:MD
Practice Address - Zip Code:20896
Practice Address - Country:US
Practice Address - Phone:301-946-4532
Practice Address - Fax:301-946-2448
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDRO43368363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics