Provider Demographics
NPI:1750104600
Name:FITZGERALD, KATELYN S (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:S
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15900 W 61ST ST S
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-3663
Mailing Address - Country:US
Mailing Address - Phone:918-688-2253
Mailing Address - Fax:
Practice Address - Street 1:401 E BROADWAY CT STE E
Practice Address - Street 2:
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-7931
Practice Address - Country:US
Practice Address - Phone:918-245-5565
Practice Address - Fax:918-245-5564
Is Sole Proprietor?:No
Enumeration Date:2024-11-07
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK220880363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily