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NPI Code Detail

MEDICARE: MELISSA J FRIESEN MS, FNP-BC

MEDICARE: MELISSA J FRIESEN MS, FNP-BC
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
1363LF0000XFamily Nurse PractitionerCOA.11033-NPOH

General Provider Information

NPI Number : 1457685083
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA J FRIESEN MS, FNP-BC
Provider Business Mailing Address
First Line : 8501 OLD TROY PIKE
Second Line :
City : HUBER HEIGHTS
State : OH
Zip : 45424-1054
Country : US
Telephone Number : 937-236-0290
Fax Number : 937-237-0519
Provider Business Practice Location Address
First Line : 8501 OLD TROY PIKE
Second Line :
City : HUBER HEIGHTS
State : OH
Zip : 45424-1054
Country : US
Telephone Number : 937-236-0290
Fax Number : 937-237-0519
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2009
Last Update Date : 09/29/2009

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