Letitia Bobbette Fritz
Individual provider Active NPI Family Nurse Practitioner · Kingsport, TN
NPI 1629517099 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1629517099
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 22241 (TN)
- Practice address
- 1905 American Way
Kingsport, TN 37660-5882 - Phone
- (423) 230-8160
- Fax
- (423) 230-8416
- NPI assigned
- Feb 18, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250108003614 | VA | Order and Referring Only - Nurse Practitioner | 9133405137 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024174677 | VA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Vein Center PLLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0024174677 | VA | |
| Family Nurse Practitioner | 363LF0000X | 22241 | TN | Yes |
Addresses
Primary practice location
1905 American Way
Kingsport, TN 37660-5882
Mailing address
105 W Stone Dr Ste 6a
Kingsport, TN 37660-3256
Phone (423) 408-7220
Other providers in Kingsport, TN
- Amy French
- Robin Leigh Freyling
- Friends in Need
- Friends in Need Health Center
- Dawn Lacy Fritz
- Frontier Health
- Frontier Health
- Frontier Health
- Frontier Health
- Frontier Health
All providers in Kingsport, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.