Crystal Renee' Fitzgerald

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

2003006979 Issued in MO

Practice address

1785 San Ricardo Dr Apt 6
Saint Louis, MO 63138-1940

Phone

(314) 477-0623

NPI assigned

Mar 18, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1237334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237334400000",
    "number": "1477794634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1785 SAN RICARDO DR APT 6",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631381940",
            "telephone_number": "314-477-0623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1785 SAN RICARDO DR APT 6",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631381940",
            "telephone_number": "314-477-0623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "CRYSTAL",
        "middle_name": "RENEE'",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-18",
        "last_updated": "2009-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MO",
            "license": "2003006979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Fitter, LCSW
• Vanessa L Fitts, FNP-C
• Anne M Fitz, PNP
• Julia N Fitzer, AA
• Adam Joseph Fitzgerald, M.D.
• Jill Fitzgerald
• John Thomas Fitzgerald, CRNA
• Kelsey Marie Fitzgerald, CRNA
• Megan M Fitzgerald, MSW, PLCSW
• Michael David Fitzgerald, RPH

• Licensed Practical Nurse in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Licensed Practical Nurse in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.