MEDICARE: PATRICIA GAIL FITCH FNP

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	363LF0000X	Family Nurse Practitioner	4704083993	MI

General Provider Information

NPI Number	:	1891787412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA GAIL FITCH FNP

Provider Business Mailing Address
First Line	:	4730 HOWLAND RD
Second Line	:
City	:	ALMONT
State	:	MI
Zip	:	48003-8521
Country	:	US
Telephone Number	:	810-798-3134
Fax Number	:

Provider Business Practice Location Address
First Line	:	G2138 W CARPENTER RD
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48505-1977
Country	:	US
Telephone Number	:	810-760-5076
Fax Number	:	810-760-5072

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

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	07/08/2007

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