Provider Demographics
NPI:1912292137
Name:FRITZ, CYNTHIA ANN (LPN)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ANN
Last Name:FRITZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8400 CHILDRENS HOME BRADFORD RD
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45308-9577
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8400 CHILDRENS HOME BRADFORD RD
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:OH
Practice Address - Zip Code:45308-9577
Practice Address - Country:US
Practice Address - Phone:937-216-0103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-15
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN077233-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse