Individual
PROF. JENNIFER D.K. FIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
10 WOODLAND ROAD, SAINT HELENA, CA 94574-9554
(707) 963-3611
(707) 995-1407
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
NP18646
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
NA95000258
CA
Other
Enumeration date
12/10/2008
Last updated
02/08/2016
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