Provider Demographics
NPI:1255997045
Name:FRIAL, MARIE KRISTIN FIRMALINO (NP-C)
Entity type:Individual
Prefix:
First Name:MARIE KRISTIN
Middle Name:FIRMALINO
Last Name:FRIAL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:KRISTIN CARIDAD
Other - Middle Name:FIRMALINO
Other - Last Name:FRIAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:340 E AVENUE I STE 108
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-1941
Mailing Address - Country:US
Mailing Address - Phone:661-729-8655
Mailing Address - Fax:661-949-3538
Practice Address - Street 1:340 E AVENUE I STE 108
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535-1941
Practice Address - Country:US
Practice Address - Phone:661-729-8655
Practice Address - Fax:661-949-3538
Is Sole Proprietor?:No
Enumeration Date:2019-05-16
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95011791363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily