Provider Demographics
NPI:1073923041
Name:FITZPATRICK, JANENE
Entity Type:Individual
Prefix:
First Name:JANENE
Middle Name:
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2253 ATLANTIC ST NE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-4470
Mailing Address - Country:US
Mailing Address - Phone:330-373-4500
Mailing Address - Fax:330-373-4511
Practice Address - Street 1:2253 ATLANTIC ST NE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-4470
Practice Address - Country:US
Practice Address - Phone:330-373-4500
Practice Address - Fax:330-373-4511
Is Sole Proprietor?:No
Enumeration Date:2014-04-30
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN191176163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse