Individual
NICOLE K FITTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2115 S FREMONT AVE STE 3300, SPRINGFIELD, MO 65804-2246
(417) 820-5200
Mailing address
2115 S FREMONT AVE STE 3300, SPRINGFIELD, MO 65804-2246
(417) 820-5200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2018006454
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220051469
—
MO
Enumeration date
03/02/2018
Last updated
05/01/2019
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