Provider Demographics
NPI:1215726450
Name:FITZGERALD, NEKIAH
Entity type:Individual
Prefix:
First Name:NEKIAH
Middle Name:
Last Name:FITZGERALD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2390 PARK CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-4650
Mailing Address - Country:US
Mailing Address - Phone:614-290-0078
Mailing Address - Fax:
Practice Address - Street 1:2390 PARK CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-4650
Practice Address - Country:US
Practice Address - Phone:614-290-0078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider