Individual
MR. KEVIN D FRITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2024 S 6TH ST, BRAINERD, MN 56401-4529
(218) 828-7100
Mailing address
PO BOX 1450, MINNEAPOLIS, MN 55485-7813
(701) 364-4222
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R113511-0
MN
363LA2200X
Adult Health Nurse Practitioner
Primary
CNP1528
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500009865
RAILRIAD MEDICARE
MN
05
—
928170300
—
MN
Enumeration date
01/25/2006
Last updated
04/26/2017
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