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Individual
MS. HEATHER FITZPATRICK
Active
Individual
MS. HEATHER FITZPATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA053057
PA
363A00000X
Physician Assistant
Primary
PA08935
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25-1716306
HEALTHNET/TRICARE
PA
01
—
50076559
CAPITAL BLUECROSS
PA
01
—
867633
MEDICARE GROUP #
PA
01
—
MA053057
LICENSE
PA
01
—
P00691422
RAILROAD MEDICARE
PA
Enumeration date
07/20/2007
Last updated
06/03/2015
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