Provider Demographics
NPI:1548856941
Name:FRITTS, TINA OVERBEE (MS,RD,LDN,CDCES)
Entity type:Individual
Prefix:MRS
First Name:TINA
Middle Name:OVERBEE
Last Name:FRITTS
Suffix:
Gender:F
Credentials:MS,RD,LDN,CDCES
Other - Prefix:MS
Other - First Name:TINA
Other - Middle Name:LOUISE
Other - Last Name:OVERBEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,RD,LDN
Mailing Address - Street 1:5510 NOBLE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:COLFAX
Mailing Address - State:NC
Mailing Address - Zip Code:27235-8006
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5510 NOBLE VIEW DR
Practice Address - Street 2:
Practice Address - City:COLFAX
Practice Address - State:NC
Practice Address - Zip Code:27235-8006
Practice Address - Country:US
Practice Address - Phone:336-686-0020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-19
Last Update Date:2020-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
915206133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered