Individual
JACQUELINE FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
909 SAGAMORE PKWY W, WEST LAFAYETTE, IN 47906-1443
(765) 463-6262
(765) 463-9122
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71016397A
IN
Other
Enumeration date
12/09/2024
Last updated
05/30/2025
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