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NPI Code Detail

MEDICARE: ARIELLA FRAZIER

MEDICARE: ARIELLA FRAZIER
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerA005832AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1A005832OTHERARLICENSE
22018008709OTHERARCERTIFICATION NUMBER

General Provider Information

NPI Number : 1871073577
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARIELLA FRAZIER
Provider Business Mailing Address
First Line : 5 MONT BLANC CV
Second Line :
City : MAUMELLE
State : AR
Zip : 72113-6044
Country : US
Telephone Number : 501-786-1019
Fax Number :
Provider Business Practice Location Address
First Line : 2255 STURGIS RD
Second Line :
City : CONWAY
State : AR
Zip : 72034-8029
Country : US
Telephone Number : 501-858-3048
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2018
Last Update Date : 03/07/2023

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Directions to “ ARIELLA FRAZIER ” Practice Location

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