MEDICARE: MARY KINSLEY FRASIER PA

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
1	363A00000X	Physician Assistant	4695	TN
2	363A00000X	Physician Assistant	15-03210	KS

General Provider Information

NPI Number	:	1619543691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY KINSLEY FRASIER PA

Provider Business Mailing Address
First Line	:	300 20TH AVE N STE 403
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37203-5180
Country	:	US
Telephone Number	:	611-539-6682
Fax Number	:

Provider Business Practice Location Address
First Line	:	20805 W 151ST ST STE 400B
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66061-7249
Country	:	US
Telephone Number	:	913-588-1227
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2021
Last Update Date	:	01/14/2026

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Directions to “ MARY KINSLEY FRASIER PA” Practice Location

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