Provider Demographics
NPI:1750641197
Name:FITZER, ANDREA PATRICIA (NP)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:PATRICIA
Last Name:FITZER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:PATRICIA
Other - Last Name:GABICA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, RN, ACNP-BC
Mailing Address - Street 1:3729 E TAHITI DR
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-5343
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:497-106-0039
Practice Address - Street 1:3729 E TAHITI DR
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-5343
Practice Address - Country:US
Practice Address - Phone:208-880-3196
Practice Address - Fax:497-106-0039
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-18
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP-1162A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner