Provider Demographics
NPI:1932400868
Name:FRITZ, AMY (RD, LD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:FRITZ
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:564 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:FLEMINGSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41041-1120
Mailing Address - Country:US
Mailing Address - Phone:606-776-6255
Mailing Address - Fax:
Practice Address - Street 1:564 LAKESIDE DR
Practice Address - Street 2:
Practice Address - City:FLEMINGSBURG
Practice Address - State:KY
Practice Address - Zip Code:41041-1120
Practice Address - Country:US
Practice Address - Phone:606-776-6255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-09
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1228133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered