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NPI Code Detail

MEDICARE: SARAH L FRASSICA NP

MEDICARE: SARAH L FRASSICA NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner2173SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225160062
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH L FRASSICA NP
Provider Business Mailing Address
First Line : PO BOX 743904
Second Line :
City : ATLANTA
State : GA
Zip : 30374-3904
Country : US
Telephone Number : 803-296-7329
Fax Number : 803-293-7330
Provider Business Practice Location Address
First Line : 1801 SUNSET DR
Second Line :
City : COLUMBIA
State : SC
Zip : 29203-6803
Country : US
Telephone Number : 803-434-4100
Fax Number : 803-434-4160
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2007
Last Update Date : 02/24/2020

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