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PROF. JENNIFER D.K. FIDGE CRNA

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1225273824

Individual Registrant:
PROF. JENNIFER D.K. FIDGE CRNA
Gender: F
Sole Proprietor

Location and contact information for practice:
10 WOODLAND ROAD  SAINT HELENA, CA 94574-9554 US
Tel: 707-963-3611  Fax: 707-995-1407

Contact information for business:
PO BOX 7096  STOCKTON, CA 95267-0096 US
Tel: 209-956-7725  Fax: 209-956-7733

Registration Information:
NPI: 1225273824
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
CANP18646
Y367500000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Anesthetist, Certified Registered
CANA95000258

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS CA - Page 1



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