Healthcare Provider Details

I. General information

NPI: 1053468215
Provider Name (Legal Business Name): RUTH ANN FRITZ CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6465 S YALE AVE STE 401
TULSA OK
74136-7806
US

IV. Provider business mailing address

802 S JACKSON AVE STE 301
TULSA OK
74127-9057
US

V. Phone/Fax

Practice location:
  • Phone: 918-561-6141
  • Fax: 918-582-3593
Mailing address:
  • Phone: 918-582-3154
  • Fax: 918-582-3593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberR0033989
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR33989
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: