Provider Demographics
NPI:1437337110
Name:FITZGERALD, BRENNA LEANNE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:BRENNA
Middle Name:LEANNE
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2501 CRESTWOOD RD STE 204
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-7616
Mailing Address - Country:US
Mailing Address - Phone:501-819-0901
Mailing Address - Fax:501-492-6478
Practice Address - Street 1:2501 CRESTWOOD RD STE 204
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-7616
Practice Address - Country:US
Practice Address - Phone:501-819-0901
Practice Address - Fax:501-492-6478
Is Sole Proprietor?:No
Enumeration Date:2008-02-05
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03058363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner