Provider Demographics
NPI: | 1306859566 |
---|---|
Name: | FROESCHLE, JANET A (CNM) |
Entity Type: | Individual |
Prefix: | |
First Name: | JANET |
Middle Name: | A |
Last Name: | FROESCHLE |
Suffix: | |
Gender: | F |
Credentials: | CNM |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 4320 DIPLOMACY DR |
Mailing Address - Street 2: | |
Mailing Address - City: | ANCHORAGE |
Mailing Address - State: | AK |
Mailing Address - Zip Code: | 99508-5925 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 907-729-3100 |
Mailing Address - Fax: | 907-729-3170 |
Practice Address - Street 1: | 4320 DIPLOMACY DR |
Practice Address - Street 2: | |
Practice Address - City: | ANCHORAGE |
Practice Address - State: | AK |
Practice Address - Zip Code: | 99508-5925 |
Practice Address - Country: | US |
Practice Address - Phone: | 907-729-3100 |
Practice Address - Fax: | 907-729-3170 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-08-15 |
Last Update Date: | 2014-05-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
AK | 228 | 367A00000X |
AK | 8584 | 163W00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 367A00000X | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife | |
No | 163W00000X | Nursing Service Providers | Registered Nurse |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
AK | NP3607 | Medicaid | |
AK | P55368 | Medicare UPIN | |
AK | 8EZ32E | Medicare ID - Type Unspecified |