Healthcare Provider Details

I. General information

NPI: 1760152961
Provider Name (Legal Business Name): RACHEL FRAZIER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2021
Last Update Date: 09/18/2021
Certification Date: 09/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 W GALLERIA DR
HENDERSON NV
89011-4800
US

IV. Provider business mailing address

437 VIA STRETTO AVE
HENDERSON NV
89011-0836
US

V. Phone/Fax

Practice location:
  • Phone: 702-963-7301
  • Fax:
Mailing address:
  • Phone: 402-802-6457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number836164
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: