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Individual

MR. WILLIAM HANS FRICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA/APRN

Contact information

Practice address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Mailing address
132 LEDGE RD, PLAINVILLE, CT 06062-2526
(860) 747-8140

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
000179
CT
367500000X
Certified Registered Nurse Anesthetist
Primary
000179
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004269800
CT
Enumeration date
08/02/2006
Last updated
07/16/2012
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