Provider Demographics
NPI:1619369055
Name:FITZ, ELIZABETH Y (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:Y
Last Name:FITZ
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FATHER DEVALLES BLVD UNIT 3
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02723-1511
Mailing Address - Country:US
Mailing Address - Phone:508-730-1209
Mailing Address - Fax:
Practice Address - Street 1:1 FATHER DEVALLES BLVD UNIT 3
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02723-1511
Practice Address - Country:US
Practice Address - Phone:508-730-1209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA126180363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner