Provider Demographics
NPI:1043106974
Name:FRASIER, SHAMICA R
Entity type:Individual
Prefix:MS
First Name:SHAMICA
Middle Name:R
Last Name:FRASIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:183 GLEN HAVEN RD
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06513-1109
Mailing Address - Country:US
Mailing Address - Phone:203-901-7551
Mailing Address - Fax:
Practice Address - Street 1:183 GLEN HAVEN RD
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06513-1109
Practice Address - Country:US
Practice Address - Phone:203-901-7551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty