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Individual

ROSEMARY EILEEN FITZPATRICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
119 GANNETT DR, SOUTH PORTLAND, ME 04106-6942
(207) 773-0040
Mailing address
119 GANNETT DR, SOUTH PORTLAND, ME 04106-6942
(207) 773-0040

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA2257
ME
363AS0400X
Surgical Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA2257
MAINE BOARD OF LICENSURE IN MEDICINE
ME
Enumeration date
02/17/2015
Last updated
01/10/2022
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