Provider Demographics
NPI:1912008152
Name:FRITZ-BECKERS, MOLLY S (MS RN PMHCNS BC)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:S
Last Name:FRITZ-BECKERS
Suffix:
Gender:F
Credentials:MS RN PMHCNS BC
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:S
Other - Last Name:FRITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS RN PMHCNS BC
Mailing Address - Street 1:750 EAST 34TH ST.
Mailing Address - Street 2:FAIRVIEW MEDICAL CENTER
Mailing Address - City:HIBBING
Mailing Address - State:MN
Mailing Address - Zip Code:55746
Mailing Address - Country:US
Mailing Address - Phone:218-362-6711
Mailing Address - Fax:218-213-9055
Practice Address - Street 1:RANGE MENTAL HEALTH CENTER PERPICH BUILDING
Practice Address - Street 2:3203 W 3RD AVE
Practice Address - City:HIBBING
Practice Address - State:MN
Practice Address - Zip Code:55746
Practice Address - Country:US
Practice Address - Phone:218-263-9237
Practice Address - Fax:218-262-3150
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1456077364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNR-145607-7OtherMN RN LICENSE
MN998123300Medicaid
MN1912008152OtherNPPES NPI
MN30125578OtherANCC CERTIFICATION
MNMF0731299OtherDEA
MNMF0731299OtherDEA
MN890000208Medicare ID - Type Unspecified