MEDICARE: MRS. CAROLE ANNETTE FRUSCELLO CRNA

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	367500000X	Certified Registered Nurse Anesthetist	APN2372	SC

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

General Provider Information

NPI Number	:	1538121397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAROLE ANNETTE FRUSCELLO CRNA

Provider Business Mailing Address
First Line	:	300 E MCBEE AVE
Second Line	:	FL 4
City	:	GREENVILLE
State	:	SC
Zip	:	29601-2842
Country	:	US
Telephone Number	:	864-522-8603
Fax Number	:

Provider Business Practice Location Address
First Line	:	1545 SOUTH WELLS AVENUE SUITE 106
Second Line	:	ATCA,INC.
City	:	RENO
State	:	NV
Zip	:	89502
Country	:	US
Telephone Number	:	864-414-9576
Fax Number	:

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

Provider Enumeration Date	:	04/05/2006
Last Update Date	:	01/29/2022

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