=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225995632
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HOLLY FRITCH PA-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/07/2026
-----------------------------------------------------
Last Update Date | 01/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2408 E 81ST ST STE 300
-----------------------------------------------------
City | TULSA
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74137-4215
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-477-5000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 810 SE 9TH ST
-----------------------------------------------------
City | PRYOR
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74361-7210
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | 5789
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------