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NPI Code Detail

MEDICARE: DR. ANN FITZGERALD PHD

MEDICARE:  DR. ANN  FITZGERALD  PHD
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
1363L00000XNurse Practitioner209029996IL
2363L00000XNurse Practitioner71001506AIN

General Provider Information

NPI Number : 1396255063
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANN FITZGERALD PHD
Provider Business Mailing Address
First Line : 4017 N TAMARACK RD
Second Line :
City : WALKERTON
State : IN
Zip : 46574-9261
Country : US
Telephone Number : 574-360-9838
Fax Number :
Provider Business Practice Location Address
First Line : 3100 45TH ST STE 3
Second Line :
City : HIGHLAND
State : IN
Zip : 46322-3277
Country : US
Telephone Number : 888-998-7337
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2017
Last Update Date : 08/04/2025

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Directions to “ DR. ANN FITZGERALD PHD” Practice Location

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