Provider Demographics
NPI:1538766472
Name:FRAZIER, ANNA LEIGH
Entity type:Individual
Prefix:MS
First Name:ANNA
Middle Name:LEIGH
Last Name:FRAZIER
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 1:306 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-4215
Mailing Address - Country:US
Mailing Address - Phone:419-961-1275
Mailing Address - Fax:
Practice Address - Street 1:306 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-4215
Practice Address - Country:US
Practice Address - Phone:419-961-1275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4204742Medicaid