Provider Demographics
NPI:1902104011
Name:FRIMML, SHIELA M (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:SHIELA
Middle Name:M
Last Name:FRIMML
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 US HIGHWAY 61
Mailing Address - Street 2:SUITE 340
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-4100
Mailing Address - Country:US
Mailing Address - Phone:636-937-1545
Mailing Address - Fax:636-937-8995
Practice Address - Street 1:1400 HIGHWAY 61
Practice Address - Street 2:SUITE 340
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-4100
Practice Address - Country:US
Practice Address - Phone:636-937-1545
Practice Address - Fax:636-937-8995
Is Sole Proprietor?:No
Enumeration Date:2011-03-14
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002007996367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2002007996OtherMISSOURI STATE BOARD OF NURSING