Healthcare Provider Details

I. General information

NPI: 1689588048
Provider Name (Legal Business Name): MELISSA FITZGIBBON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12919 STROH RANCH CT UNIT G
PARKER CO
80134-7709
US

IV. Provider business mailing address

3038 FURTHERMORE PT
CASTLE ROCK CO
80108-7910
US

V. Phone/Fax

Practice location:
  • Phone: 720-779-1442
  • Fax:
Mailing address:
  • Phone: 678-478-4277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.1002519-AP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: