Provider Demographics
NPI:1508366485
Name:FITZGERALD, MARCY ANTOINETTE (APRN, NP-C)
Entity Type:Individual
Prefix:
First Name:MARCY
Middle Name:ANTOINETTE
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:MARCY
Other - Middle Name:ANTOINETTE
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 43543
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45243-0543
Mailing Address - Country:US
Mailing Address - Phone:513-376-3493
Mailing Address - Fax:
Practice Address - Street 1:1411 COMPTON RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231
Practice Address - Country:US
Practice Address - Phone:513-522-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH15698363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health