Individual
MS. NAN ISABEL FITZ GERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN CDE
Contact information
Practice address
1040 NW 22ND AVE STE 540, PORTLAND, OR 97210-3097
(503) 413-6077
(503) 413-6888
Mailing address
1040 NW 22ND AVE STE 540, PORTLAND, OR 97210-3097
(503) 413-6077
(503) 413-6888
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
087006811RN
OR
Other
Enumeration date
11/28/2017
Last updated
11/28/2017
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