Provider Demographics
NPI:1740807668
Name:FRITCHLEY, CAROL JANE (PA)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:JANE
Last Name:FRITCHLEY
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:PO BOX 1510
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47706-1510
Mailing Address - Country:US
Mailing Address - Phone:812-450-6815
Mailing Address - Fax:812-450-6822
Practice Address - Street 1:350 W COLUMBIA ST STE 200
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-1756
Practice Address - Country:US
Practice Address - Phone:812-425-2646
Practice Address - Fax:812-467-7209
Is Sole Proprietor?:No
Enumeration Date:2020-06-26
Last Update Date:2020-08-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN10003009A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant