MEDICARE: KELSEY JANE FRITZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse	1154131	TX

General Provider Information

NPI Number	:	1013879881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEY JANE FRITZ

Provider Business Mailing Address
First Line	:	13448 N 18TH DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-1638
Country	:	US
Telephone Number	:	530-723-2659
Fax Number	:

Provider Business Practice Location Address
First Line	:	13448 N 18TH DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-1638
Country	:	US
Telephone Number	:	530-723-2659
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2025
Last Update Date	:	12/01/2025

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