Provider Demographics
NPI:1053865386
Name:FRITTS, MARLA (RN)
Entity type:Individual
Prefix:
First Name:MARLA
Middle Name:
Last Name:FRITTS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2227 RIVER PLAZA DR APT 409
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95833-3800
Mailing Address - Country:US
Mailing Address - Phone:209-200-0027
Mailing Address - Fax:
Practice Address - Street 1:2227 RIVER PLAZA DR APT 409
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95833-3800
Practice Address - Country:US
Practice Address - Phone:209-200-0027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-03
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA802302163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse