Healthcare Provider Details

I. General information

NPI: 1396829495
Provider Name (Legal Business Name): TARA K FRASER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 WHITEHALL ROAD SUITE 301
ROCHESTER NH
03867
US

IV. Provider business mailing address

21 WHITEHALL ROAD SUITE 301
ROCHESTER NH
03867
US

V. Phone/Fax

Practice location:
  • Phone: 603-692-6066
  • Fax: 603-664-7205
Mailing address:
  • Phone: 603-692-6066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number409
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: