Provider Demographics
NPI:1407882350
Name:FITZPATRICK, ANNE M (PNP)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:M
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:M
Other - Last Name:MENTRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PNP
Mailing Address - Street 1:2015 UPPERGATE DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-0001
Mailing Address - Country:US
Mailing Address - Phone:404-727-4788
Mailing Address - Fax:404-727-5045
Practice Address - Street 1:2015 UPPERGATE DR
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-0001
Practice Address - Country:US
Practice Address - Phone:404-727-4788
Practice Address - Fax:404-727-5045
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN168632363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics