Individual
JESSICA ANN FITZWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
186 HOSPITAL DR, GRANTSVILLE, WV 26147-7100
(304) 354-9244
(304) 354-9323
Mailing address
186 HOSPITAL DR, GRANTSVILLE, WV 26147-7100
(304) 354-9244
(304) 354-9323
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
75755
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
75755
LICENSE NUMBER
WV
Enumeration date
01/07/2014
Last updated
02/12/2015
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