Provider Demographics
NPI:1225047947
Name:FITZPATRICK, ANN-MARIE (ANP-BC)
Entity Type:Individual
Prefix:MS
First Name:ANN-MARIE
Middle Name:
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 DAVENPORT RD
Mailing Address - Street 2:
Mailing Address - City:BIG FLATS
Mailing Address - State:NY
Mailing Address - Zip Code:14814-7912
Mailing Address - Country:US
Mailing Address - Phone:607-737-4958
Mailing Address - Fax:
Practice Address - Street 1:ELMIRA PSYCHIATRIC CENTER
Practice Address - Street 2:100 WASHINGTON STREET
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901
Practice Address - Country:US
Practice Address - Phone:607-737-4958
Practice Address - Fax:607-737-4813
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF302214363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ12491Medicare UPIN