Provider Demographics
NPI:1558668970
Name:FITZGERALD, PATRICIA EILEEN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:EILEEN
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 OCTOBER DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-3471
Mailing Address - Country:US
Mailing Address - Phone:508-440-5280
Mailing Address - Fax:
Practice Address - Street 1:35 OCTOBER DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-3471
Practice Address - Country:US
Practice Address - Phone:508-440-5280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-21
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN67634164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse