Provider Demographics
NPI:1104082270
Name:FRAZIER, CAROL ANN II
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:FRAZIER
Suffix:II
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 1:37 DEVON RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:44904-1018
Mailing Address - Country:US
Mailing Address - Phone:419-564-2440
Mailing Address - Fax:
Practice Address - Street 1:37 DEVON RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:OH
Practice Address - Zip Code:44904-1018
Practice Address - Country:US
Practice Address - Phone:419-564-2440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN049294164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse