Provider Demographics
NPI:1265831341
Name:FITZPATRICK, ASHLEY DAWN (PA)
Entity Type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:DAWN
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:PA
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Other - Last Name:
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Mailing Address - Street 1:1450 E VALLEY RD UNIT 102
Mailing Address - Street 2:
Mailing Address - City:BASALT
Mailing Address - State:CO
Mailing Address - Zip Code:81621-8352
Mailing Address - Country:US
Mailing Address - Phone:980-424-4779
Mailing Address - Fax:
Practice Address - Street 1:1450 E VALLEY RD UNIT 102
Practice Address - Street 2:
Practice Address - City:BASALT
Practice Address - State:CO
Practice Address - Zip Code:81621-8352
Practice Address - Country:US
Practice Address - Phone:980-927-4666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0004100363A00000X
CO4100363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant