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NPI Code Detail

MEDICARE: SALLIE ELANE FITZPATRICK

MEDICARE:   SALLIE ELANE FITZPATRICK
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
1163W00000XRegistered NurseRN203607GA
2363LW0102XWomen's Health Nurse PractitionerRN203607GA

General Provider Information

NPI Number : 1275941429
Entity Type Code : Individual
Provider Name (Legal Business Name) : SALLIE ELANE FITZPATRICK
Provider Business Mailing Address
First Line : 345 N HARRIS ST
Second Line :
City : ATHENS
State : GA
Zip : 30601-2411
Country : US
Telephone Number : 706-552-4594
Fax Number :
Provider Business Practice Location Address
First Line : 345 N HARRIS ST
Second Line :
City : ATHENS
State : GA
Zip : 30601-2411
Country : US
Telephone Number : 706-552-4594
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2014
Last Update Date : 07/31/2014

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Directions to “ SALLIE ELANE FITZPATRICK ” Practice Location

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