Provider Demographics
NPI:1487686978
Name:FRITZ, STEPHANIE (LM, CPM)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:FRITZ
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 E CRISTINA AVE
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-4109
Mailing Address - Country:US
Mailing Address - Phone:520-459-3730
Mailing Address - Fax:
Practice Address - Street 1:2111 E CRISTINA AVE
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-4109
Practice Address - Country:US
Practice Address - Phone:520-459-3730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ130176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife