Provider Demographics
NPI:1952657298
Name:FRITZ, JULIA H (NP)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:H
Last Name:FRITZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 SAN MATEO BLVD. NE7
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CO
Mailing Address - Zip Code:87108-1434
Mailing Address - Country:US
Mailing Address - Phone:505-265-3511
Mailing Address - Fax:505-268-4350
Practice Address - Street 1:233 E 2ND ST
Practice Address - Street 2:
Practice Address - City:SALIDA
Practice Address - State:CO
Practice Address - Zip Code:81201-2116
Practice Address - Country:US
Practice Address - Phone:719-539-7291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO205658163WG0000X
COAPN.0995742-CNM363LF0000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000195075Medicaid