Provider Demographics
NPI:1649258237
Name:FRITH, ELIZABETH W (NP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:W
Last Name:FRITH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 T B STANLEY HWY
Mailing Address - Street 2:SUITE B AND C
Mailing Address - City:BASSETT
Mailing Address - State:VA
Mailing Address - Zip Code:24055-6108
Mailing Address - Country:US
Mailing Address - Phone:276-638-2523
Mailing Address - Fax:276-638-2669
Practice Address - Street 1:324 T B STANLEY HWY
Practice Address - Street 2:SUITE B AND C
Practice Address - City:BASSETT
Practice Address - State:VA
Practice Address - Zip Code:24055-6108
Practice Address - Country:US
Practice Address - Phone:276-638-2523
Practice Address - Fax:276-638-2669
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024066549363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily