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NPI Code Detail

MEDICARE: MRS. JENELL SUZANNE FITZGERALD PCPNP

MEDICARE:  MRS. JENELL SUZANNE FITZGERALD  PCPNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse PractitionerAPRN.CNP.10253OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255667895
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENELL SUZANNE FITZGERALD PCPNP
Provider Business Mailing Address
First Line : 2222 CHERRY ST STE 1900
Second Line :
City : TOLEDO
State : OH
Zip : 43608-2673
Country : US
Telephone Number : 419-251-3878
Fax Number :
Provider Business Practice Location Address
First Line : 6855 SPRING VALLEY DR STE 125
Second Line :
City : HOLLAND
State : OH
Zip : 43528-9374
Country : US
Telephone Number : 419-389-1444
Fax Number : 419-407-3515
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2009
Last Update Date : 07/21/2025

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