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General NPI Number Information
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NPI Number | 1699050161
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Entity Type | Individual
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Provider Name | TARA LEE FRAZIER-RICE FNP
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Gender | Female
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Dates
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Enumeration Date | 10/17/2011
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Last Update Date | 11/18/2014
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Provider Practice Location Address
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Address Line | 400 W HERSEY ST SUITE 1
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City | ASHLAND
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State | OR
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Zip | 97520-1864
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Country | US
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Telephone | 541-482-7047
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Fax | 541-552-1009
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Provider Business Mailing Address
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Address Line | 1411 EVERGREEN LN
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City | ASHLAND
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State | OR
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Zip | 97520-1602
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Country | US
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Telephone | 541-821-5304
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 097000451RN
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201391242NP-PP
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License Number State | OR
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