Healthcare Provider Details

I. General information

NPI: 1205542404
Provider Name (Legal Business Name): ERIKA FRAZIER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2023
Last Update Date: 01/31/2023
Certification Date: 01/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2163 S THATCHER CIR # 95
WICHITA KS
67207-5611
US

IV. Provider business mailing address

2163 S THATCHER CIR # 95
WICHITA KS
67207-5611
US

V. Phone/Fax

Practice location:
  • Phone: 316-648-6322
  • Fax:
Mailing address:
  • Phone: 316-648-6322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number13-155075-121
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: