Provider Demographics
NPI:1740783802
Name:FRITZ, AMANDA (RN)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:FRITZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:F
Other - Last Name:FRITZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:9179 TRELAWNEY CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45251-3034
Mailing Address - Country:US
Mailing Address - Phone:513-284-2237
Mailing Address - Fax:
Practice Address - Street 1:9179 TRELAWNEY CT
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45251-3034
Practice Address - Country:US
Practice Address - Phone:513-284-2237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-15
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH441073163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse