Provider Demographics
NPI:1114990249
Name:FRIE, ANGELA M (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:M
Last Name:FRIE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 SAINT JAMES PL
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-1439
Mailing Address - Country:US
Mailing Address - Phone:412-596-9572
Mailing Address - Fax:
Practice Address - Street 1:520 SAINT JAMES PL
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1439
Practice Address - Country:US
Practice Address - Phone:412-596-9572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-09
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN355401L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101303463Medicaid
PAP93056Medicare UPIN
PA101303463Medicaid