Jo Beth Fritz, RN

Individual provider Active NPI School Registered Nurse · Bloomfield, NM

NPI 1992911275 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1992911275
Entity type
Individual (NPI type 1)
Primary specialty
School Registered Nurse 163WS0200X
License
R 22079 (NM)
Practice address
520 N 1St St
Bloomfield, NM 87413-5307
Phone
(505) 634-3405
Fax
(505) 634-3413
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R 22079NMMDSchool Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X R 22079 NM Yes

Addresses

Primary practice location

520 N 1St St
Bloomfield, NM 87413-5307

Mailing address

635 Road 2900
Aztec, NM 87410-1040
Phone (505) 664-3405

Other identifiers

IdentifierTypeStateIssuer
64434826MedicaidNM

Other providers in Bloomfield, NM

All providers in Bloomfield, NM · School Registered Nurse in New Mexico

Sources for this page

Verify at the official NPI Registry.