Organization
FITZGERALD PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARNISHA LATASHA FITZGERALD (OWNER)
(443) 763-7154
Entity
Organization
Contact information
Practice address
2232 E MONUMENT ST, BALTIMORE, MD 21205-2431
(667) 207-3552
Mailing address
2232 E MONUMENT ST, BALTIMORE, MD 21205-2431
(667) 207-3552
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/29/2023
Last updated
05/16/2024
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