Healthcare Provider Details

I. General information

NPI: 1750628137
Provider Name (Legal Business Name): AUTUMN FRANDSEN ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2013
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

176 THOMAS JOHNSON DR STE 204
FREDERICK MD
21702-4538
US

IV. Provider business mailing address

8067 CLIFFROSE CT
PLAIN CITY OH
43064-6039
US

V. Phone/Fax

Practice location:
  • Phone: 301-378-9683
  • Fax: 855-774-4264
Mailing address:
  • Phone: 804-652-9642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberNP-0034
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNP034
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: