Healthcare Provider Details

I. General information

NPI: 1073130027
Provider Name (Legal Business Name): KATIE ANN FRAZIER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATIE ANN SANSONE

II. Dates (important events)

Enumeration Date: 06/25/2020
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 RANDOLPH RD
HOWELL NJ
07731-8611
US

IV. Provider business mailing address

705 ORANGE CENTER RD
ORANGE CT
06477-1830
US

V. Phone/Fax

Practice location:
  • Phone: 866-708-1240
  • Fax:
Mailing address:
  • Phone: 203-444-6919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number008778
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: