Provider Demographics
NPI:1326069105
Name:FITZSIMMONS, KERI ANN (MD)
Entity Type:Individual
Prefix:
First Name:KERI
Middle Name:ANN
Last Name:FITZSIMMONS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4519 DOLWICK DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6528
Mailing Address - Country:US
Mailing Address - Phone:919-321-8988
Mailing Address - Fax:
Practice Address - Street 1:300 MARKET ST STE 112
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-4493
Practice Address - Country:US
Practice Address - Phone:919-969-9611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-00874208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics