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NPI Code Detail

MEDICARE: MS. MELISSA HANNER FRISVOLD CNM

MEDICARE: MS. MELISSA HANNER FRISVOLD CNM
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
1367A00000XAdvanced Practice MidwifeR1182312MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528041043
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MELISSA HANNER FRISVOLD CNM
Provider Business Mailing Address
First Line : 1687E DIVISION ST
Second Line :
City : RIVER FALLS
State : WI
Zip : 54022-1571
Country : US
Telephone Number : 715-425-6701
Fax Number :
Provider Business Practice Location Address
First Line : 921 GREELEY ST S
Second Line :
City : STILLWATER
State : MN
Zip : 55082-5935
Country : US
Telephone Number : 651-439-1234
Fax Number : 651-439-1547
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2005
Last Update Date : 12/30/2015

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