Provider Demographics
NPI:1568125920
Name:FRITSCH, MEAGAN (DNP, CRNA)
Entity Type:Individual
Prefix:DR
First Name:MEAGAN
Middle Name:
Last Name:FRITSCH
Suffix:
Gender:F
Credentials:DNP, CRNA
Other - Prefix:
Other - First Name:MEAGAN
Other - Middle Name:
Other - Last Name:LAFFERTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:434 CENTURY VISTA DR
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012-1204
Mailing Address - Country:US
Mailing Address - Phone:410-703-5674
Mailing Address - Fax:
Practice Address - Street 1:700 MELVIN AVE STE 7
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1506
Practice Address - Country:US
Practice Address - Phone:410-280-2260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR211495367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered