Provider Demographics
NPI:1851844385
Name:FRITZGES, KRISTI L (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:L
Last Name:FRITZGES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:KRISTI
Other - Middle Name:L
Other - Last Name:NOECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5623 PULPIT PEAK VW
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-3954
Mailing Address - Country:US
Mailing Address - Phone:719-365-1292
Mailing Address - Fax:719-365-6997
Practice Address - Street 1:1 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-9350
Practice Address - Country:US
Practice Address - Phone:570-522-4260
Practice Address - Fax:570-522-4155
Is Sole Proprietor?:No
Enumeration Date:2016-08-02
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA058266363A00000X
COPA.0006868363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant