Provider Demographics
NPI:1982429361
Name:FITZGERALD, HANNAH NOEL
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:NOEL
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7458 E CHEROKEE DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-6080
Mailing Address - Country:US
Mailing Address - Phone:678-751-9201
Mailing Address - Fax:
Practice Address - Street 1:7458 E CHEROKEE DR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-6080
Practice Address - Country:US
Practice Address - Phone:678-751-9201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant