Healthcare Provider Details

I. General information

NPI: 1952749269
Provider Name (Legal Business Name): KRYSTEN ANNE MARIE FRITZ NORTH M.D., M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2013
Last Update Date: 05/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MANNING DR RM N4051N
CHAPEL HILL NC
27514
US

IV. Provider business mailing address

101 MANNING DR RM N4051N
CHAPEL HILL NC
27514-4220
US

V. Phone/Fax

Practice location:
  • Phone: 984-974-5063
  • Fax:
Mailing address:
  • Phone: 984-974-5063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD60658460
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2018-00599
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1952749269
Identifier TypeMEDICAID
Identifier StateWA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: