Provider Demographics
NPI:1871215707
Name:FITZHUGH, HAROLD CHADWICK (FNP-C)
Entity type:Individual
Prefix:
First Name:HAROLD
Middle Name:CHADWICK
Last Name:FITZHUGH
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2416 LOWER BROWNSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38301-9655
Mailing Address - Country:US
Mailing Address - Phone:731-431-4458
Mailing Address - Fax:
Practice Address - Street 1:2416 LOWER BROWNSVILLE RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-9655
Practice Address - Country:US
Practice Address - Phone:731-431-4458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-16
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000145290163WE0003X
TN32784363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency