Provider Demographics
NPI:1386375640
Name:FRITTON, BERNALDA KAY (APRN)
Entity type:Individual
Prefix:MS
First Name:BERNALDA
Middle Name:KAY
Last Name:FRITTON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62998 736 RD
Mailing Address - Street 2:
Mailing Address - City:BROCK
Mailing Address - State:NE
Mailing Address - Zip Code:68320-8416
Mailing Address - Country:US
Mailing Address - Phone:646-662-7576
Mailing Address - Fax:
Practice Address - Street 1:202 HIGH ST
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:NE
Practice Address - Zip Code:68450-2443
Practice Address - Country:US
Practice Address - Phone:402-335-3361
Practice Address - Fax:402-335-6342
Is Sole Proprietor?:No
Enumeration Date:2022-06-18
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE114234363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE114234OtherAPRN LICENSE NUMBER