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NPI Code Detail

MEDICARE: ANDREA FRESEN

MEDICARE: ANDREA FRESEN
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1710422365
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA FRESEN
Provider Business Mailing Address
First Line : 25 KESSEL CT
Second Line : STE 105
City : MADISON
State : WI
Zip : 53711-6227
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2000 FORDEM AVE
Second Line :
City : MADISON
State : WI
Zip : 53704-4600
Country : US
Telephone Number : 608-280-2740
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2017
Last Update Date : 01/05/2017

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Directions to “ ANDREA FRESEN ” Practice Location

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