Provider Demographics
NPI:1952950065
Name:FRITZ, MARA JOAN (NP)
Entity type:Individual
Prefix:
First Name:MARA
Middle Name:JOAN
Last Name:FRITZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MARA
Other - Middle Name:JOAN
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:920 E 28TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1195
Mailing Address - Country:US
Mailing Address - Phone:612-863-6800
Mailing Address - Fax:612-863-6006
Practice Address - Street 1:920 E 28TH ST STE 300
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1195
Practice Address - Country:US
Practice Address - Phone:612-863-6800
Practice Address - Fax:612-863-6006
Is Sole Proprietor?:No
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6837363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care