Healthcare Provider Details

I. General information

NPI: 1457351751
Provider Name (Legal Business Name): JANIS LYN FRAZEE RNC MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 05/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6051 FRANKFORT HWY SUITE 100
BENZONIA MI
49616-9558
US

IV. Provider business mailing address

7426 S ROSINSKI RD
CEDAR MI
49621-9605
US

V. Phone/Fax

Practice location:
  • Phone: 231-882-2230
  • Fax: 231-882-2204
Mailing address:
  • Phone: 231-228-7173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number4704124608
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: