=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053468215
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RUTH ANN FRITZ CNS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/03/2007
-----------------------------------------------------
Last Update Date | 02/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6465 S YALE AVE STE 401
-----------------------------------------------------
City | TULSA
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74136-7806
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-561-6141
-----------------------------------------------------
Fax | 918-582-3593
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 802 S JACKSON AVE STE 301
-----------------------------------------------------
City | TULSA
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74127-9057
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-582-3154
-----------------------------------------------------
Fax | 918-582-3593
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 364S00000X
-----------------------------------------------------
Taxonomy Name | Clinical Nurse Specialist
-----------------------------------------------------
License Number | R0033989
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | R33989
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------