Provider Demographics
NPI:1902790116
Name:FITZGERALD, RYLEE JOLISSA
Entity type:Individual
Prefix:
First Name:RYLEE
Middle Name:JOLISSA
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 1:361 N 46TH ST APT 3411
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68132-3277
Mailing Address - Country:US
Mailing Address - Phone:701-200-9728
Mailing Address - Fax:
Practice Address - Street 1:361 N 46TH ST APT 3411
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68132-3277
Practice Address - Country:US
Practice Address - Phone:701-200-9728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion