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NPI Code Detail

MEDICARE: LAURA FRAZIER PMHNP-BC

MEDICARE: LAURA FRAZIER PMHNP-BC
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner10549-33WI

General Provider Information

NPI Number : 1396349114
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA FRAZIER PMHNP-BC
Provider Business Mailing Address
First Line : 4810 NORTHWESTERN AVE
Second Line :
City : MOUNT PLEASANT
State : WI
Zip : 53406-1504
Country : US
Telephone Number : 262-583-2714
Fax Number :
Provider Business Practice Location Address
First Line : 4810 NORTHWESTERN AVE
Second Line :
City : MOUNT PLEASANT
State : WI
Zip : 53406-1504
Country : US
Telephone Number : 262-583-2714
Fax Number : 262-583-2785
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2020
Last Update Date : 12/03/2020

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Directions to “ LAURA FRAZIER PMHNP-BC” Practice Location

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