Healthcare Provider Details

I. General information

NPI: 1457717019
Provider Name (Legal Business Name): CHRISTY FITZPATRICK NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2016
Last Update Date: 09/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1479 N RIVER RD
FREMONT OH
43420-9760
US

IV. Provider business mailing address

PO BOX 378
SANDUSKY OH
44871-0378
US

V. Phone/Fax

Practice location:
  • Phone: 419-355-9440
  • Fax: 419-355-9443
Mailing address:
  • Phone: 419-609-1112
  • Fax: 419-609-1123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number18526-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: