Doctor Name: | JULIE ELDREDGE FITZGERALD |
NPI Number: | 1982987749 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | PA2011-0028 |
Business Practice Address: | 530 Demoss Street Hidalgo Medical Services Lordsburg, NM - 880452618 |
Business Phone Number: | 5755428384 |
Business Fax Number: | 5755422328 |
Mailing Address: | 530 Demoss Street, LORDSBURG |
State: | NM |
Postal Code: | 880452618 |
Phone Number: | 5755428384 |
Fax Number: | 5755428367 |
NPI Enumeration Date: | 09/27/2011 |
NPI Last Update Date: | 03/27/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA2011-0028 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |