Provider Demographics
NPI:1063845519
Name:FITZPATRICK, JENNIFER RUTH (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:RUTH
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:RUTH
Other - Last Name:THOMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1222 S PATTERSON BLVD
Mailing Address - Street 2:STE 400
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-2642
Mailing Address - Country:US
Mailing Address - Phone:937-496-2620
Mailing Address - Fax:937-424-8518
Practice Address - Street 1:1222 S PATTERSON BLVD
Practice Address - Street 2:STE 400
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-2642
Practice Address - Country:US
Practice Address - Phone:937-496-2620
Practice Address - Fax:937-424-8518
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.14906-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily