Healthcare Provider Details

I. General information

NPI: 1669382560
Provider Name (Legal Business Name): DEBORAH ANN FRAZEY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9700 W 76TH ST
EDEN PRAIRIE MN
55344-4201
US

IV. Provider business mailing address

6778 IVY WOOD AVE
LINO LAKES MN
55038-4707
US

V. Phone/Fax

Practice location:
  • Phone: 952-206-4380
  • Fax:
Mailing address:
  • Phone: 763-370-1252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number116346
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: