| NPI | 1235314840 |
|---|---|
| Former Name | SHANNON FITZGERALD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 14348) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 0050-03854) |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2016-11-17 |