| Doctor Name: | PROF. JENNIFER D.K. FIDGE |
| NPI Number: | 1225273824 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNA |
| License Number: | NP18646 |
| Business Practice Address: | 10 Woodland Road Saint Helena, CA - 945749554 |
| Business Phone Number: | 7079633611 |
| Business Fax Number: | 7079951407 |
| Mailing Address: | Po Box 7096, STOCKTON |
| State: | CA |
| Postal Code: | 952670096 |
| Phone Number: | 2099567725 |
| Fax Number: | 2099567733 |
| NPI Enumeration Date: | 12/10/2008 |
| NPI Last Update Date: | 02/08/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | NP18646 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |