MEDICARE: FRI FLORENCE FON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	NP1046909	DC
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	R230198	MD

General Provider Information

NPI Number	:	1699039164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRI FLORENCE FON

Provider Business Mailing Address
First Line	:	5 CALEB CT
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-4847
Country	:	US
Telephone Number	:	857-991-9562
Fax Number	:

Provider Business Practice Location Address
First Line	:	216 MICHIGAN AVE NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20017-1095
Country	:	US
Telephone Number	:	857-991-9562
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2012
Last Update Date	:	07/07/2025

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Directions to “ FRI FLORENCE FON ” Practice Location

Language	Start Address	Practice Location

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