Provider Demographics
NPI:1356518104
Name:FRISQUE, SABRINA LESLIE (RN)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:LESLIE
Last Name:FRISQUE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 POTTS AVE
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54304-4535
Mailing Address - Country:US
Mailing Address - Phone:920-491-9079
Mailing Address - Fax:920-491-9082
Practice Address - Street 1:835 POTTS AVE
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54304-4535
Practice Address - Country:US
Practice Address - Phone:920-491-9079
Practice Address - Fax:920-491-9082
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI105001-030163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health