Healthcare Provider Details

I. General information

NPI: 1760459366
Provider Name (Legal Business Name): LORRAINE A FRITZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

US ARMY MEDDAC HEIDELBERG CMR 442
APO AE
09042
DE

IV. Provider business mailing address

ATTN: CREDENTIALS OFFICE CMR 442
APO AE
09042
DE

V. Phone/Fax

Practice location:
  • Phone: 496221172326
  • Fax: 496221172570
Mailing address:
  • Phone: 06221172326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number0024127905
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: