Individual
MRS. MARY G FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
6121 N HANLEY RD, BERKELEY, MO 63134-2003
(314) 615-0600
(314) 615-8303
Mailing address
6121 N HANLEY RD, BERKELEY, MO 63134-2003
(314) 615-0600
(314) 615-8303
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
065417
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
425013323
—
MO
Enumeration date
08/19/2006
Last updated
09/25/2012
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