Provider Demographics
NPI:1154805018
Name:FRITZ, LISA (APRN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:
Last Name:FRITZ
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3838 SHOPES CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CATLETTSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41129-8494
Mailing Address - Country:US
Mailing Address - Phone:606-331-1876
Mailing Address - Fax:
Practice Address - Street 1:3838 SHOPES CREEK RD
Practice Address - Street 2:
Practice Address - City:CATLETTSBURG
Practice Address - State:KY
Practice Address - Zip Code:41129-8494
Practice Address - Country:US
Practice Address - Phone:606-331-1876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN58016NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily