Basic Information
| Provider Information | |||||||||
| NPI: | 1679584650 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRIZZERA | ||||||||
| FirstName: | JOELLE | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1935 BABBS CT | ||||||||
| Address2: | |||||||||
| City: | MARRIOTTSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211041110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105526280 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6190 GEORGETOWN BLVD | ||||||||
| Address2: | |||||||||
| City: | ELDERSBURG | ||||||||
| State: | MD | ||||||||
| PostalCode: | 217846460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105525050 | ||||||||
| FaxNumber: | 4105520200 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | R117575 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.