Provider Demographics
NPI:1679535884
Name:FRIGON, CAROLYN KAY (MSN FNP)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:KAY
Last Name:FRIGON
Suffix:
Gender:F
Credentials:MSN FNP
Other - Prefix:MISS
Other - First Name:CAROLYN
Other - Middle Name:KAY
Other - Last Name:BEARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2141 HIGH STREET
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:CA
Mailing Address - Zip Code:93662
Mailing Address - Country:US
Mailing Address - Phone:559-856-6110
Mailing Address - Fax:559-856-6108
Practice Address - Street 1:2141 HIGH ST
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:CA
Practice Address - Zip Code:93662-3065
Practice Address - Country:US
Practice Address - Phone:559-856-6110
Practice Address - Fax:559-856-6108
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA541793163W00000X
CA12482363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACU265ZMedicare PIN
P37781Medicare UPIN