Healthcare Provider Details

I. General information

NPI: 1487892220
Provider Name (Legal Business Name): DONNA C. FRAYSIER MSN, ACNS-BC, APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2009
Last Update Date: 08/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 STOUT DRIVE NICKS HALL, ROOM 160
JOHNSON CITY TN
37614
US

IV. Provider business mailing address

PO BOX 70403
JOHNSON CITY TN
37614-1703
US

V. Phone/Fax

Practice location:
  • Phone: 423-439-4225
  • Fax: 423-439-4560
Mailing address:
  • Phone: 423-439-4515
  • Fax: 423-439-5780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberAPN0000013716
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: