MEDICARE: ELIZABETH W FRITH NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	0024066549	VA

General Provider Information

NPI Number	:	1649258237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH W FRITH NP

Provider Business Mailing Address
First Line	:	324 T B STANLEY HWY
Second Line	:	SUITE B AND C
City	:	BASSETT
State	:	VA
Zip	:	24055-6108
Country	:	US
Telephone Number	:	276-638-2523
Fax Number	:	276-638-2669

Provider Business Practice Location Address
First Line	:	324 T B STANLEY HWY
Second Line	:	SUITE B AND C
City	:	BASSETT
State	:	VA
Zip	:	24055-6108
Country	:	US
Telephone Number	:	276-638-2523
Fax Number	:	276-638-2669

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	01/02/2008

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