Provider Demographics
NPI:1356682066
Name:FRIZZELL, MAEGEN N (PA-C)
Entity Type:Individual
Prefix:
First Name:MAEGEN
Middle Name:N
Last Name:FRIZZELL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 GLENWOOD DR STE E680
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-1176
Mailing Address - Country:US
Mailing Address - Phone:423-206-4140
Mailing Address - Fax:423-206-4141
Practice Address - Street 1:725 GLENWOOD DR STE E680
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-1176
Practice Address - Country:US
Practice Address - Phone:234-206-4140
Practice Address - Fax:423-206-4141
Is Sole Proprietor?:No
Enumeration Date:2013-03-05
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2197363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant