Provider Demographics
NPI:1275597890
Name:KRITZ, COLLEEN M (CFNP)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:M
Last Name:KRITZ
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 42935
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28309-2935
Mailing Address - Country:US
Mailing Address - Phone:910-615-6914
Mailing Address - Fax:910-615-4609
Practice Address - Street 1:1638 OWEN DR.
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3424
Practice Address - Country:US
Practice Address - Phone:910-615-6914
Practice Address - Fax:910-615-4609
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200943363LF0000X, 364SX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SX0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncology
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCA0021OtherMEDCOST
NCA0021OtherMEDCOST
2594891Medicare UPIN
NC2594891Medicare ID - Type Unspecified