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General NPI Number Information
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NPI Number | 1619693918
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Entity Type | Individual
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Provider Name | TORI NICOLE FRAZIER LPN
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Gender | Female
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Dates
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Enumeration Date | 10/18/2022
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Last Update Date | 10/18/2022
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Provider Practice Location Address
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Address Line | 5570 WHITTAKER RD
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City | YPSILANTI
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State | MI
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Zip | 48197-9752
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Country | US
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Telephone | 734-800-9916
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Fax |
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Provider Business Mailing Address
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Address Line | 1143 S JOHN HIX ST
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City | WESTLAND
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State | MI
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Zip | 48186-3742
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Country | US
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Telephone | 734-604-1106
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 4703121722
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License Number State | MI
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