Healthcare Provider Details

I. General information

NPI: 1013142330
Provider Name (Legal Business Name): LORITHA ANN FITZPATRICK CPM, LM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2009
Last Update Date: 09/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8522 OLD OLYMPIC HWY
SEQUIM WA
98382-6812
US

IV. Provider business mailing address

8522 OLD OLYMPIC HWY
SEQUIM WA
98382-6812
US

V. Phone/Fax

Practice location:
  • Phone: 843-254-5435
  • Fax:
Mailing address:
  • Phone: 843-254-5435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberLMW-0041
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW60130114
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: