Healthcare Provider Details

I. General information

NPI: 1881104875
Provider Name (Legal Business Name): VIRGINIA L FRAZIER DNP, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2017
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3737 SOUTHERN BLVD STE 4200
KETTERING OH
45429-0135
US

IV. Provider business mailing address

3737 SOUTHERN BLVD STE 4200
KETTERING OH
45429-0135
US

V. Phone/Fax

Practice location:
  • Phone: 937-294-1489
  • Fax: 937-294-7999
Mailing address:
  • Phone: 937-294-1489
  • Fax: 937-294-7999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0036161
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2289085
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: