Provider Demographics
NPI:1295863298
Name:FITZGERALD, MARGARET ELIZABETH (NP)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:ELIZABETH
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:17 LAWRENCE LN
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-8216
Mailing Address - Country:US
Mailing Address - Phone:781-861-7525
Mailing Address - Fax:
Practice Address - Street 1:175 FOREST ST
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02452-4705
Practice Address - Country:US
Practice Address - Phone:781-891-2222
Practice Address - Fax:781-891-3443
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA173173363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner