Provider Demographics
NPI:1750061354
Name:FRASCOLLA, ANGELICA (RN)
Entity type:Individual
Prefix:
First Name:ANGELICA
Middle Name:
Last Name:FRASCOLLA
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 1:280 AUBURN ST
Mailing Address - Street 2:
Mailing Address - City:CHERRY VALLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01611-3327
Mailing Address - Country:US
Mailing Address - Phone:774-366-4501
Mailing Address - Fax:
Practice Address - Street 1:45 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-2345
Practice Address - Country:US
Practice Address - Phone:800-841-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2326468163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse