Healthcare Provider Details

I. General information

NPI: 1083033302
Provider Name (Legal Business Name): NAKIA FRAZIER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 04/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1433 CLOVERDALE DR
SAVANNAH GA
31415-7891
US

IV. Provider business mailing address

1433 CLOVERDALE DR
SAVANNAH GA
31415
UM

V. Phone/Fax

Practice location:
  • Phone: 912-503-0472
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: