Nan Isabel Fitz Gerald, RN CDE

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

087006811RN Issued in OR

Practice address

1040 NW 22ND Ave Ste 540
Portland, OR 97210-3097

Phone

(503) 413-6077

Fax

(503) 413-6888

NPI assigned

Nov 28, 2017

Last updated

Nov 28, 2017By the provider in NPPES

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

Other names 1

• Ms. Nan I. Fitz Gerald Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1511827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511827200000",
    "number": "1619481744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 NW 22ND AVE STE 540",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103097",
            "telephone_number": "503-413-6077",
            "fax_number": "503-413-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 NW 22ND AVE STE 540",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103097",
            "telephone_number": "503-413-6077",
            "fax_number": "503-413-6888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZ GERALD",
        "first_name": "NAN",
        "middle_name": "ISABEL",
        "name_prefix": "Ms.",
        "credential": "RN CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-28",
        "last_updated": "2017-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "OR",
            "license": "087006811RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NAN",
            "last_name": "FITZ GERALD",
            "middle_name": "I.",
            "prefix": "MS.",
            "credential": "087006811RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Alannah Fitkin
• Courtney Fitkin
• Fitness & Function LLC
• Molly E Fitterer, DPT
• Torin Patrick Fitton, M.D.
• Morgan Elizabeth Fitz Gibbon, LMFT
• Conor Fitz, PSYD
• Michelle Anne Fitz, M.ED.
• Savannah Fitz
• Brooke Kreitner Fitzgerald, FNP

• Diabetes Educator Registered Nurse in Portland, OR
• Providers in Portland, OR by specialty
• Diabetes Educator Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2017; 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.