Healthcare Provider Details

I. General information

NPI: 1922398379
Provider Name (Legal Business Name): TINA A. FRISINA APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2011
Last Update Date: 01/15/2021
Certification Date: 01/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13207 RAVENNA RD
CHARDON OH
44024-7032
US

IV. Provider business mailing address

20800 HARVARD RD 2ND FLOOR
HIGHLAND HILLS OH
44122-7251
US

V. Phone/Fax

Practice location:
  • Phone: 440-285-2960
  • Fax: 440-285-2959
Mailing address:
  • Phone: 216-358-2315
  • Fax: 216-201-7237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.12298-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: