Healthcare Provider Details

I. General information

NPI: 1225995632
Provider Name (Legal Business Name): HOLLY FRITCH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2408 E 81ST ST STE 300
TULSA OK
74137-4215
US

IV. Provider business mailing address

810 SE 9TH ST
PRYOR OK
74361-7210
US

V. Phone/Fax

Practice location:
  • Phone: 918-477-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5789
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: