1740578962 NPI number — ADRIANNE MAXINE FRIEMEL

Table of content: ADRIANNE MAXINE FRIEMEL (NPI 1740578962)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740578962 NPI number — ADRIANNE MAXINE FRIEMEL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRIEMEL
Provider First Name:
ADRIANNE
Provider Middle Name:
MAXINE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740578962
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/31/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1201 WHISPERING PINES WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FITCHBURG
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53713-4328
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-344-7585
Provider Business Mailing Address Fax Number:
608-203-4544

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 HIGHLAND AVE
Provider Second Line Business Practice Location Address:
MC 2433
Provider Business Practice Location Address City Name:
MADISON
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53792-1530
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
608-662-0817
Provider Business Practice Location Address Fax Number:
608-203-4544
Provider Enumeration Date:
07/21/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  49933 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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