Provider Demographics
NPI:1144581034
Name:FRITZ, MARCY
Entity Type:Individual
Prefix:
First Name:MARCY
Middle Name:
Last Name:FRITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 3RD AVE SE
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-4508
Mailing Address - Country:US
Mailing Address - Phone:605-225-1010
Mailing Address - Fax:605-225-1017
Practice Address - Street 1:628 CIRCLE DR
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-2615
Practice Address - Country:US
Practice Address - Phone:605-225-1010
Practice Address - Fax:605-225-1017
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR015444163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health