Provider Demographics
NPI:1598542342
Name:JULIE MADELYN FRISBIE-KNUDSEN PMHNP, PLLC
Entity Type:Organization
Organization Name:JULIE MADELYN FRISBIE-KNUDSEN PMHNP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:MADELYN
Authorized Official - Last Name:FRISBIE-KNUDSEN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:352-290-2767
Mailing Address - Street 1:4703 NW 53RD AVE STE A2
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32653-3403
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4703 NW 53RD AVE STE A2
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32653-3403
Practice Address - Country:US
Practice Address - Phone:352-290-2767
Practice Address - Fax:352-290-0064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-13
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty