Provider Demographics
NPI:1639144777
Name:FITZGERALD, KAREN ROSE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ROSE
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:ROSE
Other - Last Name:BRUNI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:391 MYRTLE AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3797
Mailing Address - Country:US
Mailing Address - Phone:518-262-5640
Mailing Address - Fax:518-262-9413
Practice Address - Street 1:391 MYRTLE AVE., SUITE 5
Practice Address - Street 2:THE VASCULAR GROUP, PLLC
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3412
Practice Address - Country:US
Practice Address - Phone:518-262-5640
Practice Address - Fax:518-262-9413
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY331703363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02250739Medicaid
NY02250737Medicaid
S55829Medicare UPIN
NY02250737Medicaid