Individual
LARISSA KATHLEEN FRAUENHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2501 N PATTERSON ST, VALDOSTA, GA 31602-1785
(229) 443-1000
Mailing address
2036 SEA HAWK CIR, PONTE VEDRA BEACH, FL 32082-1679
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
RN287176
GA
363LF0000X
Family Nurse Practitioner
Primary
RN9336400
FL
Other
Enumeration date
08/29/2019
Last updated
08/29/2019
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