Provider Demographics
NPI:1346394863
Name:FRUGE, MARIA L (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:L
Last Name:FRUGE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4127 BRUSH CREEK RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80916-5523
Mailing Address - Country:US
Mailing Address - Phone:719-638-7996
Mailing Address - Fax:719-638-7996
Practice Address - Street 1:4127 BRUSH CREEK RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80916-5523
Practice Address - Country:US
Practice Address - Phone:719-638-7996
Practice Address - Fax:719-638-7996
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO59616163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant