Healthcare Provider Details

I. General information

NPI: 1831592161
Provider Name (Legal Business Name): ANGELA MARIE FITZPATRICK FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2014
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 PHYSICIANS WAY STE 120
LEBANON TN
37090-4134
US

IV. Provider business mailing address

2004 HAYES ST STE 800
NASHVILLE TN
37203-2659
US

V. Phone/Fax

Practice location:
  • Phone: 615-453-5623
  • Fax: 615-453-8592
Mailing address:
  • Phone: 615-329-0570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-180220
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number19154
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: