Provider Demographics
NPI:1750641197
Name:FITZER, ANDREA PATRICIA (NP)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:PATRICIA
Last Name:FITZER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:PATRICIA
Other - Last Name:GABICA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4400 E. FLAMINGO AVE
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83687
Mailing Address - Country:US
Mailing Address - Phone:208-302-0860
Mailing Address - Fax:208-302-0865
Practice Address - Street 1:4400 E. FLAMINGO AVE
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83687
Practice Address - Country:US
Practice Address - Phone:208-302-0860
Practice Address - Fax:208-302-0865
Is Sole Proprietor?:No
Enumeration Date:2012-05-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP-1162A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner