Healthcare Provider Details

I. General information

NPI: 1467835116
Provider Name (Legal Business Name): HEATHER FRAZER DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2015
Last Update Date: 06/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3981 W ROY FURMAN HWY
WAYNESBURG PA
15370-2575
US

IV. Provider business mailing address

3981 W ROY FURMAN HWY
WAYNESBURG PA
15370-2575
US

V. Phone/Fax

Practice location:
  • Phone: 724-627-0389
  • Fax:
Mailing address:
  • Phone: 724-627-0389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number49698
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: