Provider Demographics
NPI:1285940387
Name:FITZPATRICK, LAURIE ANN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:ANN
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4151 45TH ST S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-4312
Mailing Address - Country:US
Mailing Address - Phone:701-282-8075
Mailing Address - Fax:
Practice Address - Street 1:4151 45TH ST S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-4312
Practice Address - Country:US
Practice Address - Phone:701-282-8075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND5155183500000X
NV14292183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist