Provider Demographics
NPI:1245841659
Name:FREDRITZ, LEVI LLOYD (FNP-C)
Entity type:Individual
Prefix:MR
First Name:LEVI
Middle Name:LLOYD
Last Name:FREDRITZ
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6622 SUNBURY RD
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-8215
Mailing Address - Country:US
Mailing Address - Phone:419-340-7036
Mailing Address - Fax:
Practice Address - Street 1:75 HOSPITAL DR STE 370
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2867
Practice Address - Country:US
Practice Address - Phone:419-340-7036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0027106363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health