Provider Demographics
NPI:1124688254
Name:FRISELLA, STARRANN
Entity type:Individual
Prefix:
First Name:STARRANN
Middle Name:
Last Name:FRISELLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60454 N TRANQUILITY RD
Mailing Address - Street 2:
Mailing Address - City:LACOMBE
Mailing Address - State:LA
Mailing Address - Zip Code:70445-4123
Mailing Address - Country:US
Mailing Address - Phone:985-788-7070
Mailing Address - Fax:
Practice Address - Street 1:700 GAUSE BLVD
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2800
Practice Address - Country:US
Practice Address - Phone:985-326-8501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator