Provider Demographics
NPI:1508162306
Name:FRIMPONG, SHIRLEY (ANP)
Entity Type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:
Last Name:FRIMPONG
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:SHIRLEY
Other - Middle Name:
Other - Last Name:COFFIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5205 CHAIRMANS CT STE 201A
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-2918
Mailing Address - Country:US
Mailing Address - Phone:240-629-3939
Mailing Address - Fax:
Practice Address - Street 1:5205 CHAIRMANS CT STE 201A
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-2918
Practice Address - Country:US
Practice Address - Phone:240-629-3939
Practice Address - Fax:240-629-3945
Is Sole Proprietor?:No
Enumeration Date:2011-01-27
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024169024363LA2200X
MDR174469363LA2200X
MDAC000866363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD754030200Medicaid