Provider Demographics
NPI:1164196119
Name:FRIERSON, ANGELA M (PROSTHETIST)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:FRIERSON
Suffix:
Gender:F
Credentials:PROSTHETIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17025
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-0025
Mailing Address - Country:US
Mailing Address - Phone:501-200-4565
Mailing Address - Fax:
Practice Address - Street 1:1212 BITTERCRESS DR
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-9779
Practice Address - Country:US
Practice Address - Phone:501-246-9310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-03
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist