Provider Demographics
NPI:1629627641
Name:FRIZZELL, KATHERINE METZGER (CNM)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:METZGER
Last Name:FRIZZELL
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:JOANNE
Other - Last Name:METZGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 772437
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48277-2437
Mailing Address - Country:US
Mailing Address - Phone:317-575-7304
Mailing Address - Fax:317-575-7333
Practice Address - Street 1:7495 STATE RD STE 300
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-6402
Practice Address - Country:US
Practice Address - Phone:513-231-3447
Practice Address - Fax:513-231-3761
Is Sole Proprietor?:No
Enumeration Date:2019-09-11
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI148988-32367A00000X
OHAPRN.CNM.0019515367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife