Healthcare Provider Details

I. General information

NPI: 1619317633
Provider Name (Legal Business Name): PATRICIA MARY FITZGERALD R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PATRICIA MARY CURRAN R.N.

II. Dates (important events)

Enumeration Date: 07/05/2013
Last Update Date: 07/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3075 HEALTH CENTER DR SUITE 401
SAN DIEGO CA
92123-2773
US

IV. Provider business mailing address

3075 HEALTH CENTER DR SUITE 401
SAN DIEGO CA
92123-2773
US

V. Phone/Fax

Practice location:
  • Phone: 858-939-5400
  • Fax:
Mailing address:
  • Phone: 858-939-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberRN475511
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: