Provider Demographics
NPI:1558789412
Name:FITZGERALD, ANN MARIE (CFNP, MSN, RN)
Entity Type:Individual
Prefix:MS
First Name:ANN MARIE
Middle Name:
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:CFNP, MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 WILSON RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-7834
Mailing Address - Country:US
Mailing Address - Phone:831-649-9200
Mailing Address - Fax:
Practice Address - Street 1:23625 WR HOLMAN HWY
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5902
Practice Address - Country:US
Practice Address - Phone:831-624-5311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-28
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14608363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily