MEDICARE: WENDY NDIONU FRAZER APRN- CNM

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	176B00000X	Midwife	1110785	TX

General Provider Information

NPI Number	:	1790194223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY NDIONU FRAZER APRN- CNM

Provider Business Mailing Address
First Line	:	13526 TULIPWOOD NOOK
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78253-1137
Country	:	US
Telephone Number	:	917-790-3875
Fax Number	:

Provider Business Practice Location Address
First Line	:	7430 BARLITE BLVD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78224-1365
Country	:	US
Telephone Number	:	210-922-2727
Fax Number	:

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

Provider Enumeration Date	:	08/08/2014
Last Update Date	:	07/22/2024

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