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General NPI Number Information
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NPI Number | 1821480575
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Entity Type | Individual
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Provider Name | RACQUEL FRISELLA AGPCNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/03/2015
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 17247 CHESTERFIELD AIRPORT RD
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City | CHESTERFIELD
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State | MO
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Zip | 63005-1423
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Country | US
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Telephone | 636-742-1122
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Fax |
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Provider Business Mailing Address
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Address Line | 544 QUAIL RIDGE LN
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City | SAINT ALBANS
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State | MO
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Zip | 63073-1014
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Country | US
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Telephone | 314-960-9294
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 2014039708
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License Number State | MO
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