LARISSA KATHLEEN FRAUENHEIM (NPI# 1760030050) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760030050 |
| Entity Type | Individual |
| Full Name | LARISSA KATHLEEN FRAUENHEIM |
| Other Name | LARISSA KATHLEEN BRETTELL |
| Credential | APRN |
| Practice Address |
2501 N Patterson St Valdosta GA 31602-1785 |
| Mailing Address |
2036 Sea Hawk Cir Ponte Vedra Beach FL 32082-1679 |
| Practice Telephone | 2294431000 |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2019-08-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN287176 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN9336400 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2501 N PATTERSON ST |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31602-1785 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578566964 | John William Devine | Radiology | 2501 N Patterson St, Valdosta, GA 31602-1735 | 2005-05-31 |
| 1770100422 | Hospital Authority of Valdosta & Lowndes County, Ga | Clinical Medical Laboratory | 2501 N Patterson St, Valdosta, GA 31602-1735 | 2020-06-29 |
| 1700410602 | Danielle C Yund | Nurse Practitioner | 2501 N Patterson St, Valdosta, GA 31602-1735 | 2020-02-28 |
| 1417597170 | Sgmc Physician Network Inc | Emergency Medicine | 2501 N Patterson St, Valdosta, GA 31602-1735 | 2020-01-10 |
| 1497390116 | Stacey Newsome | Registered Nurse | 2501 N Patterson St, Valdosta, GA 31602-1735 | 2019-11-18 |
| 1508417296 | Coastal Plain Radiology LLC | Radiology | 2501 N Patterson St, Valdosta, GA 31602-1735 | 2019-09-24 |
| 1336794734 | Jeffery Allan Baggett | Nurse Anesthetist, Certified Registered | 2501 N Patterson St, Valdosta, GA 31602-1785 | 2019-08-03 |
| 1689130312 | Kala Jo Bugg | Nurse Practitioner | 2501 N Patterson St, Valdosta, GA 31602-1785 | 2019-02-19 |
| 1588149819 | Philip Andrew Cooper | Nurse Practitioner | 2501 N Patterson St, Valdosta, GA 31602-1785 | 2018-10-02 |
| 1053891069 | Wendy Nicole Livingston | Nurse Practitioner | 2501 N Patterson St, Valdosta, GA 31602-1785 | 2018-08-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477198117 | Amber Michele Baugh | Behavior Technician | 2236 Bemiss Road, Valdosta, GA 31602 | 2019-11-15 |
| 1528611365 | Nishaben T. Patel | Nurse Practitioner | 3120 North Oak Street Extension, Suite B, Valdosta, GA 31602 | 2019-07-22 |
| 1427615871 | Blair Elizabeth Tomlinson | Nurse Practitioner | 2124 Lakeshore Drive, Valdosta, GA 31602 | 2019-05-21 |
| 1346704152 | Mildred Itaska Borowski | Counselor | 3790 North Highway 41, Suite A, Valdosta, GA 31602 | 2019-01-25 |
| 1962991703 | Southern Healthcare Alliance, LLC | Physical Medicine & Rehabilitation | 101-f W. Northside Drive, Valdosta, GA 31602 | 2018-05-08 |
| 1336636646 | Kaitlyn Thrift | Behavioral Analyst | 2225 Bemiss Road Suite D, Valdosta, GA 31602 | 2018-04-23 |
| 1407379845 | Lindsey Marie Richardson | Dentist | 103 W. Cranford Ave, Valdosta, GA 31602 | 2017-07-18 |
| 1962922427 | Taylor Nicole Fiveash | Nurse Practitioner | 101 W Northisde Dr, Bldg G, Valdosta, GA 31602 | 2017-06-26 |
| 1720520646 | Southern Sleepers Anesthesia LLC | Nurse Anesthetist, Certified Registered | 4120-b N. Valdosta Road, Valdosta, GA 31602 | 2016-11-09 |
| 1134670557 | Cataract and Laser Surgery Center of South Georgia, P.C. | Clinic/Center | 4120-b N. Valdosta Rd., Valdosta, GA 31602 | 2016-10-20 |
| Find all providers in zip 31602 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962017368 | Katrina Terrell Horne | Nurse Practitioner | 15 Pinetree Cir, Valdosta, GA 31601-6256 | 2020-09-11 |
| 1669009585 | Cindy Renee James | Nurse Practitioner | 2517 Bemiss Rd Ste F, Valdosta, GA 31602-1900 | 2020-03-23 |
| 1629602776 | Jennifer Lynn Cason | Nurse Practitioner | 406 Northside Dr Ste M, Valdosta, GA 31602-1853 | 2020-02-27 |
| 1528611365 | Nishaben T. Patel | Nurse Practitioner | 3120 North Oak Street Extension, Suite B, Valdosta, GA 31602 | 2019-07-22 |
| 1427615871 | Blair Elizabeth Tomlinson | Nurse Practitioner | 2124 Lakeshore Drive, Valdosta, GA 31602 | 2019-05-21 |
| 1447715529 | Amanda Brunetto | Nurse Practitioner | 2418 N Oak St Ste J, Valdosta, GA 31602-2575 | 2019-02-04 |
| 1639640436 | Brad Jay Jones | Nurse Practitioner | 470 Lazy River Dr, Valdosta, GA 31602-8245 | 2018-12-06 |
| 1396215703 | James Robert Garrett | Nurse Practitioner | 3790 Old Us Highway 41 N Ste B, Valdosta, GA 31602-6866 | 2018-11-28 |
| 1508350661 | Iulian Vuc | Nurse Practitioner | 2922 N Oak St Ste A, Valdosta, GA 31602-1885 | 2018-06-21 |
| 1346732617 | Catherine Mashburn Price | Nurse Practitioner | 3116 N Oak Street Ext Ste B, Valdosta, GA 31602-1007 | 2018-06-03 |
| Find all providers in VALDOSTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.