Healthcare Provider Details

I. General information

NPI: 1407256852
Provider Name (Legal Business Name): LORI WRONOWICZ FRASHER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2014
Last Update Date: 03/14/2024
Certification Date: 03/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2209 JOHN R WOODEN DR
MARTINSVILLE IN
46151-1840
US

IV. Provider business mailing address

PO BOX 1329
BLOOMINGTON IN
47402-1329
US

V. Phone/Fax

Practice location:
  • Phone: 765-342-0539
  • Fax: 765-342-0539
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number71005100A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: