Healthcare Provider Details

I. General information

NPI: 1629895719
Provider Name (Legal Business Name): ASHLEY DANIELLE FRATER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2024
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10315 USA TODAY WAY
MIRAMAR FL
33025-3902
US

IV. Provider business mailing address

233 S WACKER DR STE 800
CHICAGO IL
60606-6415
US

V. Phone/Fax

Practice location:
  • Phone: 954-531-2259
  • Fax:
Mailing address:
  • Phone: 954-531-2259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11035076
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: