Provider Demographics
NPI:1245755404
Name:FITZPATRICK, BRYCE C (MSN, FNP-C)
Entity Type:Individual
Prefix:
First Name:BRYCE
Middle Name:C
Last Name:FITZPATRICK
Suffix:
Gender:M
Credentials:MSN, FNP-C
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:5281 N 99TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85305-2209
Mailing Address - Country:US
Mailing Address - Phone:623-516-8252
Mailing Address - Fax:623-516-8253
Practice Address - Street 1:3645 S ROME ST STE 216
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-7338
Practice Address - Country:US
Practice Address - Phone:623-516-8252
Practice Address - Fax:623-516-8253
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-09
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZAP10490363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily