| Doctor Name: | MARY ANNE FITZGERALD |
| NPI Number: | 1013021757 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 218756 |
| Business Practice Address: | 815 N Broadway Ave Tyler, TX - 757024507 |
| Business Phone Number: | 9035350023 |
| Business Fax Number: | 9035350052 |
| Mailing Address: | Po Box 2039, TYLER |
| State: | TX |
| Postal Code: | 757102039 |
| Phone Number: | 9035350023 |
| Fax Number: | 9035350052 |
| NPI Enumeration Date: | 08/19/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | 218756 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |