Basic Information
| Provider Information | |||||||||
| NPI: | 1538522297 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FITZGERALD | ||||||||
| FirstName: | HILLARY | ||||||||
| MiddleName: | MOEN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 414 ACKLEN PARK DR APT 3 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372052674 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9013782408 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1211 MEDICAL CENTER DR | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372326756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153224916 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2016 | ||||||||
| LastUpdateDate: | 04/15/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 217714 | NC | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 65354 | MN | N | Allopathic & Osteopathic Physicians | Family Medicine | 207QH0002X | 91332 | GA | Y | Allopathic & Osteopathic Physicians | Family Medicine | Hospice and Palliative Medicine |
No ID Information.