Provider Demographics
NPI:1255378154
Name:FRINK, CLIFFORD (ARNP)
Entity type:Individual
Prefix:
First Name:CLIFFORD
Middle Name:
Last Name:FRINK
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 W 9TH ST
Mailing Address - Street 2:
Mailing Address - City:HOISINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67544-1725
Mailing Address - Country:US
Mailing Address - Phone:620-653-2386
Mailing Address - Fax:620-653-4186
Practice Address - Street 1:252 W 9TH ST
Practice Address - Street 2:
Practice Address - City:HOISINGTON
Practice Address - State:KS
Practice Address - Zip Code:67544-1725
Practice Address - Country:US
Practice Address - Phone:620-653-2386
Practice Address - Fax:620-653-4186
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44214363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS161199OtherBCBS
KS161199OtherBCBS
KS161199Medicare ID - Type Unspecified