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NPI 1871268185

NPI 1871268185 : ALEXIS NICOLE FRAZIER : WAUSEON, OH

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General NPI Number Information
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    NPI Number           |    1871268185
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    Entity Type          |    Individual 
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    Provider Name        |    ALEXIS NICOLE FRAZIER
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/10/2021
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    Last Update Date     |    08/10/2021
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Provider Practice Location Address
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    Address Line         |    1496 N SHOOP AVE 
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    City                 |    WAUSEON
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    State                |    OH
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    Zip                  |    43567-1825
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    Country              |    US
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    Telephone            |    419-337-5050
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    Fax                  |    419-337-5058
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Provider Business Mailing Address
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    Address Line         |    1496 N SHOOP AVE 
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    City                 |    WAUSEON
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    State                |    OH
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    Zip                  |    43567-1825
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    Country              |    US
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    Telephone            |    419-337-5050
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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        |    183500000X
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    Taxonomy Name        |    Pharmacist
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    License Number       |    03441011
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    License Number State |    OH
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