Provider Demographics
NPI:1992785265
Name:FRITZ-MILLARD, JENNIFER AMY (ARNP, FNP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:AMY
Last Name:FRITZ-MILLARD
Suffix:
Gender:F
Credentials:ARNP, FNP
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:AMY
Other - Last Name:FRITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12023 14TH DR SE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-5916
Mailing Address - Country:US
Mailing Address - Phone:425-379-9241
Mailing Address - Fax:425-806-9475
Practice Address - Street 1:19110 BOTHELL WAY NE
Practice Address - Street 2:SUITE 206
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-2970
Practice Address - Country:US
Practice Address - Phone:425-806-8360
Practice Address - Fax:425-806-9475
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007236363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily