Provider Demographics
NPI:1609298520
Name:FRIAS, EMILZE NELLY (RN)
Entity Type:Individual
Prefix:
First Name:EMILZE
Middle Name:NELLY
Last Name:FRIAS
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 1:182 MANSION ST
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-2521
Mailing Address - Country:US
Mailing Address - Phone:703-507-5691
Mailing Address - Fax:
Practice Address - Street 1:182 MANSION ST
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-2521
Practice Address - Country:US
Practice Address - Phone:703-507-5691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-12
Last Update Date:2014-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY679223-1163W00000X
VA0001225656163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse