Healthcare Provider Details

I. General information

NPI: 1306983226
Provider Name (Legal Business Name): ANGEL MARIE FRAZIER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 N 3RD ST SUITE 170
PHOENIX AZ
85004-1471
US

IV. Provider business mailing address

1508 E HERMOSA DR
TEMPE AZ
85282-5722
US

V. Phone/Fax

Practice location:
  • Phone: 602-462-1132
  • Fax: 602-462-1186
Mailing address:
  • Phone: 480-839-0686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN098376
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: