MEDICARE: TERRYN FRAZER RDN

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	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1851261549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRYN FRAZER RDN

Provider Business Mailing Address
First Line	:	4602 LITTLE ROCK RD
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19802-1005
Country	:	US
Telephone Number	:	302-383-4182
Fax Number	:

Provider Business Practice Location Address
First Line	:	4602 LITTLE ROCK RD
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19802-1005
Country	:	US
Telephone Number	:	302-383-4182
Fax Number	:

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

Provider Enumeration Date	:	11/07/2025
Last Update Date	:	11/07/2025

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