Provider Demographics
NPI:1962732545
Name:FITZHARRIS, LUCILLE A (RN)
Entity type:Individual
Prefix:
First Name:LUCILLE
Middle Name:A
Last Name:FITZHARRIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3167 S VINE CT
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-3070
Mailing Address - Country:US
Mailing Address - Phone:303-850-5868
Mailing Address - Fax:303-850-6950
Practice Address - Street 1:3167 S VINE CT
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3070
Practice Address - Country:US
Practice Address - Phone:303-850-5868
Practice Address - Fax:303-850-6950
Is Sole Proprietor?:No
Enumeration Date:2010-01-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA56547163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator