Individual
BENJAMIN CALE FRIESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1915 LAKE AVE, PLYMOUTH, IN 46563-9366
(574) 948-4000
Mailing address
56765 COUNTY ROAD 23, BRISTOL, IN 46507-9516
(574) 238-8372
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
28203358A
IN
363LF0000X
Family Nurse Practitioner
Primary
71008991A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28203358A
INDIANA STATE BOARD OF NURSING
—
01
—
71008991A
ANP LICENSE
IN
Enumeration date
04/08/2019
Last updated
07/08/2019
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