Individual
ANTOINETTE KAMEL FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
5201 HARRY HINES BLVD, MEDICAL STAFF SERVICES, DALLAS, TX 75235-7708
(214) 590-8006
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
(214) 590-4105
(214) 590-4162
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
454874
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8Y3175
BLUE CROSS BLUE SHIELD
TX
Enumeration date
10/23/2007
Last updated
04/18/2008
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