Individual
MRS. TRACY FRITTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
969 LAKELAND DR, JACKSON, MS 39216-4606
(601) 540-5545
Mailing address
101 ST LIVIE CT, MADISON, MS 39110-4555
(601) 540-5545
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D0595
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D0595
DIETITIAN LICENSE
MS
Enumeration date
11/21/2019
Last updated
11/21/2019
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