Provider Demographics
NPI:1649224007
Name:FITZPATRICK, NANCY J (PA-C)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:J
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:DRINKWALTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 1228
Mailing Address - Street 2:
Mailing Address - City:BIG TIMBER
Mailing Address - State:MT
Mailing Address - Zip Code:59011
Mailing Address - Country:US
Mailing Address - Phone:406-932-4911
Mailing Address - Fax:
Practice Address - Street 1:301 W 7TH AVE
Practice Address - Street 2:
Practice Address - City:BIG TIMBER
Practice Address - State:MT
Practice Address - Zip Code:59011-7893
Practice Address - Country:US
Practice Address - Phone:406-932-4911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK646363A00000X
MT314363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1649224007OtherNPI #
AK8EC762Medicare ID - Type UnspecifiedMEDICARE B PROVIDER ID
MT1649224007OtherNPI #