Provider Demographics
NPI:1275510679
Name:FRANSSON, ANGELA MOLENDA (PT)
Entity Type:Individual
Prefix:PROF
First Name:ANGELA
Middle Name:MOLENDA
Last Name:FRANSSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 WAUNONA WAY
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-1525
Mailing Address - Country:US
Mailing Address - Phone:608-223-1452
Mailing Address - Fax:608-223-1459
Practice Address - Street 1:2620 WAUNONA WAY
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713-1525
Practice Address - Country:US
Practice Address - Phone:608-223-1452
Practice Address - Fax:608-223-1459
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 26410174400000X
WI9599-024174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1275510679Medicaid
CAW13096Medicare ID - Type UnspecifiedGROUP
WI1275510679Medicaid