Healthcare Provider Details

I. General information

NPI: 1932790292
Provider Name (Legal Business Name): SARA FITZGERALD PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2021
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8565 S EASTERN AVE
LAS VEGAS NV
89123-2808
US

IV. Provider business mailing address

8565 S EASTERN AVE
LAS VEGAS NV
89123-2808
US

V. Phone/Fax

Practice location:
  • Phone: 952-212-9173
  • Fax:
Mailing address:
  • Phone: 952-212-9173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: