Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 6534 | WI |
NPI | 1003292269 |
---|---|
Provider Name | Mrs. Brittany Frisque |
First Address | Hartford, WI 53027-2684 |
Second Address | Hartford, WI 53027-2684 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2015 |
Last Update Date | 19/11/2021 |