Basic Information
| Provider Information | |||||||||
| NPI: | 1497394449 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRITSCHER | ||||||||
| FirstName: | KATELYNN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 971 GRAND CANAL ST | ||||||||
| Address2: | |||||||||
| City: | GULF BREEZE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 325633054 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8507764478 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5151 N 9TH AVE | ||||||||
| Address2: | |||||||||
| City: | PENSACOLA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 325048721 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8504167000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/21/2019 | ||||||||
| LastUpdateDate: | 12/21/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/21/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 9477226 | FL | Y | Nursing Service Providers | Registered Nurse |
No ID Information.