MEDICARE: STEPHANIE NANA FRIMPONG-BADU FNP

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
1	363LF0000X	Family Nurse Practitioner	95028868	CA
2	363LF0000X	Family Nurse Practitioner	735840	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	8L3417	OTHER	TX	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	193781502	OTHER	TX	CSHCN
4	8Y4058	OTHER	TX	BCBSTX

General Provider Information

NPI Number	:	1467645234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE NANA FRIMPONG-BADU FNP

Provider Business Mailing Address
First Line	:	1 EMBARCADERO CTR STE 1900
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94111-3723
Country	:	US
Telephone Number	:	415-658-6791
Fax Number	:

Provider Business Practice Location Address
First Line	:	2717 COMMERCIAL CENTER BLVD STE D150
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-7824
Country	:	US
Telephone Number	:	888-663-6331
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2007
Last Update Date	:	04/04/2024

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