Provider Demographics
NPI:1689047896
Name:FRITSCHE, KAREN ANN (RN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ANN
Last Name:FRITSCHE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:ANN
Other - Last Name:FRITSCHE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:452 SCOTCHTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-5216
Mailing Address - Country:US
Mailing Address - Phone:845-239-3663
Mailing Address - Fax:
Practice Address - Street 1:452 SCOTCHTOWN AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-5216
Practice Address - Country:US
Practice Address - Phone:845-239-3663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-10
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY727626-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY427626-1OtherNYS