MEDICARE: KATHLEEN FITTERER N.P.

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	363L00000X	Nurse Practitioner	443680	CA

General Provider Information

NPI Number	:	1649439126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN FITTERER N.P.

Provider Business Mailing Address
First Line	:	500 LENNON LN
Second Line	:
City	:	WALNUT CREEK
State	:	CA
Zip	:	94598-2415
Country	:	US
Telephone Number	:	925-939-9610
Fax Number	:	925-939-9630

Provider Business Practice Location Address
First Line	:	500 LENNON LN
Second Line	:
City	:	WALNUT CREEK
State	:	CA
Zip	:	94598-2415
Country	:	US
Telephone Number	:	925-939-9610
Fax Number	:	925-939-9630

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

Provider Enumeration Date	:	06/09/2008
Last Update Date	:	08/27/2010

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