Provider Demographics
NPI:1114085669
Name:FITZGERALD, MARYSHEILA ANN (MA AUDC FAAA FADA)
Entity type:Individual
Prefix:MS
First Name:MARYSHEILA
Middle Name:ANN
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:MA AUDC FAAA FADA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 S 22ND DR
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-8867
Mailing Address - Country:US
Mailing Address - Phone:928-783-4476
Mailing Address - Fax:
Practice Address - Street 1:2320 S 22ND DR
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-8867
Practice Address - Country:US
Practice Address - Phone:928-783-4476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
237700000X
AZDA542231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ50113101Medicaid
S38839Medicare UPIN
AZ50113101Medicaid