MEDICARE: KRISTEN FRAZER

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
1	224Z00000X	Occupational Therapy Assistant	2365	OK

General Provider Information

NPI Number	:	1578378733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN FRAZER

Provider Business Mailing Address
First Line	:	705 26TH AVE NW
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73069-6367
Country	:	US
Telephone Number	:	405-308-9120
Fax Number	:

Provider Business Practice Location Address
First Line	:	6316 N TULSA AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-1340
Country	:	US
Telephone Number	:	405-749-4550
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2025
Last Update Date	:	02/12/2025

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Directions to “ KRISTEN FRAZER ” Practice Location

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