Provider Demographics
NPI:1477222867
Name:FRITCH, KRISTINA NICOLE (PHARMD, MBA)
Entity Type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:NICOLE
Last Name:FRITCH
Suffix:
Gender:F
Credentials:PHARMD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 ACKLEN PARK DR APT 485
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1193
Mailing Address - Country:US
Mailing Address - Phone:813-789-8698
Mailing Address - Fax:
Practice Address - Street 1:1012 GLENDALE LN
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-4159
Practice Address - Country:US
Practice Address - Phone:813-789-8698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44466183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN44466OtherPHARMACY LICENSE