Healthcare Provider Details

I. General information

NPI: 1023211513
Provider Name (Legal Business Name): MARY C FRAZEE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 04/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7514 E MONTEREY WAY SUITE 3
SCOTTSDALE AZ
85251-6900
US

IV. Provider business mailing address

7514 E MONTEREY WAY SUITE 3
SCOTTSDALE AZ
85251-6900
US

V. Phone/Fax

Practice location:
  • Phone: 480-421-9938
  • Fax: 480-429-2354
Mailing address:
  • Phone: 480-421-9938
  • Fax: 480-429-2354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP7202
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: