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General NPI Number Information
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NPI Number | 1699789305
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Entity Type | Individual
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Provider Name | ELIZABETH R FRAZIER APRN
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Gender | Female
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 02/01/2024
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Provider Practice Location Address
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Address Line | 1135 BROADWAY ST
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City | SOUTH FULTON
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State | TN
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Zip | 38257-2835
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Country | US
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Telephone | 731-479-2606
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Fax | 731-479-2610
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Provider Business Mailing Address
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Address Line | 1135 BROADWAY ST
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City | SOUTH FULTON
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State | TN
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Zip | 38257-2835
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Country | US
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Telephone | 731-479-2606
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Fax | 731-479-2610
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2205P
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 6339
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License Number State | TN
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