MEDICARE: MR. JAMIE BRIAN FITZPATRICK CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	897777	OH

General Provider Information

NPI Number	:	1588936058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMIE BRIAN FITZPATRICK CRNA

Provider Business Mailing Address
First Line	:	9500 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-5759
Country	:	US
Telephone Number	:	216-444-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-5759
Country	:	US
Telephone Number	:	216-444-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2012
Last Update Date	:	02/03/2023

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