Provider Demographics
NPI:1750628137
Name:FRANDSEN, AUTUMN (ND)
Entity type:Individual
Prefix:
First Name:AUTUMN
Middle Name:
Last Name:FRANDSEN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8067 CLIFFROSE CT
Mailing Address - Street 2:
Mailing Address - City:PLAIN CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43064-6039
Mailing Address - Country:US
Mailing Address - Phone:804-652-9642
Mailing Address - Fax:
Practice Address - Street 1:176 THOMAS JOHNSON DR STE 204
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4538
Practice Address - Country:US
Practice Address - Phone:301-378-9683
Practice Address - Fax:855-774-4264
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-06
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNP-0034207KA0200X
DCNP034175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy