Healthcare Provider Details

I. General information

NPI: 1225096001
Provider Name (Legal Business Name): CHARLOTTE M FRIRES CNM, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 11/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4110 WARRENSVILLE CENTER RD
BEACHWOOD OH
44122-7024
US

IV. Provider business mailing address

275 SPRINGSIDE DR STE 100
AKRON OH
44333-4549
US

V. Phone/Fax

Practice location:
  • Phone: 216-491-7774
  • Fax: 216-491-7775
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberRN 188002 NM 02969
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: