Healthcare Provider Details

I. General information

NPI: 1508228487
Provider Name (Legal Business Name): CHANTRA CHEYENNE FRAZIER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 MEDICAL CENTER ROAD
FORT HOOD TX
76544-5060
US

IV. Provider business mailing address

590 MEDICAL CENTER ROAD
FORT HOOD TX
76544-1782
US

V. Phone/Fax

Practice location:
  • Phone: 254-553-8100
  • Fax:
Mailing address:
  • Phone: 254-288-8888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAP124051
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: