Most Relevant Information
Provider Data
| NPI Number: | 1003689738 |
| Provider Name: | NISSA ANN FREEZE |
| Entity Type: | Individual |
| Taxonomy Code: | 163WC1500X |
| Specialty: | Registered Nurse |
| License Number: | RN649635 |
Most Important Dates
| Enumeration Date: | 11/03/2023 |
| Last Updated: | 11/03/2023 |
Provider Practice Location
507 E MARKET ST
DANVILLE
PA
178212009
Practice Location Phone/Fax
| Phone: | 1570275496 |
| Fax: |
Provider Mailing Location
507 E MARKET ST
DANVILLE
PA
178212009
Provider Mailing Phone/Fax
| Phone: | 1570275496 |
| Fax: |