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NPI Code Detail

MEDICARE: KATHRYN HELEN FRAKE PA

MEDICARE: KATHRYN HELEN FRAKE PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant5601002646MI

General Provider Information

NPI Number : 1558581355
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN HELEN FRAKE PA
Provider Business Mailing Address
First Line : 14705 W UPRIGHT ST
Second Line :
City : CHARLEVOIX
State : MI
Zip : 49720-1949
Country : US
Telephone Number : 231-547-8777
Fax Number : 231-547-8638
Provider Business Practice Location Address
First Line : 14705 W UPRIGHT ST
Second Line :
City : CHARLEVOIX
State : MI
Zip : 49720-1949
Country : US
Telephone Number : 231-547-8777
Fax Number : 231-547-8638
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2007
Last Update Date : 07/10/2014

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Directions to “ KATHRYN HELEN FRAKE PA” Practice Location

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