Provider Demographics
NPI:1487668083
Name:FITZGERALD, CYNTHIA E (ARNP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:E
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15511 N CINCINNATI ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-9582
Mailing Address - Country:US
Mailing Address - Phone:509-953-0742
Mailing Address - Fax:509-323-5827
Practice Address - Street 1:15511 N CINCINNATI ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-9582
Practice Address - Country:US
Practice Address - Phone:509-953-0742
Practice Address - Fax:509-323-5827
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004501363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9628686Medicaid
WAAB17675Medicare ID - Type Unspecified