Provider Demographics
NPI:1205164266
Name:FITZGERALD, CATHERINE (MS, PA-C)
Entity type:Individual
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First Name:CATHERINE
Middle Name:
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:MS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3676 PARKER BLVD
Mailing Address - Street 2:SUITE 390
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81008-2212
Mailing Address - Country:US
Mailing Address - Phone:719-595-7780
Mailing Address - Fax:719-595-7789
Practice Address - Street 1:4112 OUTLOOK BLVD
Practice Address - Street 2:SUITE 37
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008-1667
Practice Address - Country:US
Practice Address - Phone:719-562-6254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-01
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO3237363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant