Individual
BRIANNA FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2900 S LOOP 256, PALESTINE, TX 75801-6958
(903) 731-5128
Mailing address
2749 MC RD 3511, JEFFERSON, TX 75657
(318) 553-6449
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
1036852
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38459045
DRIVERS LICENSE
TX
Enumeration date
08/03/2022
Last updated
08/03/2022
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