Provider Demographics
NPI:1073817078
Name:FRIESENHAHN, BRITNEY ANN (PA-C)
Entity Type:Individual
Prefix:
First Name:BRITNEY
Middle Name:ANN
Last Name:FRIESENHAHN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:BRITNEY
Other - Middle Name:FRIESENHAHN
Other - Last Name:COPPEDGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:1500 UNIVERSITY DR E
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77840-2600
Mailing Address - Country:US
Mailing Address - Phone:979-846-1100
Mailing Address - Fax:979-260-9390
Practice Address - Street 1:1905 DOVE CROSSING LN
Practice Address - Street 2:SUITE C
Practice Address - City:NAVASOTA
Practice Address - State:TX
Practice Address - Zip Code:77868-5272
Practice Address - Country:US
Practice Address - Phone:936-825-0000
Practice Address - Fax:936-825-8001
Is Sole Proprietor?:No
Enumeration Date:2011-01-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06917363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000951607Medicaid
TX1700973187OtherGRIMES CHC NPI
TX1821185299OtherBVCAA AGENCY NPI
TX000951607Medicaid