Provider Demographics
NPI:1548355860
Name:FRAZIER, LONNIE FAYE (RN)
Entity type:Individual
Prefix:MRS
First Name:LONNIE
Middle Name:FAYE
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2033 W BEAUREGARD AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76901-3883
Mailing Address - Country:US
Mailing Address - Phone:325-944-8900
Mailing Address - Fax:325-947-0101
Practice Address - Street 1:2033 W BEAUREGARD AVE
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76901-3883
Practice Address - Country:US
Practice Address - Phone:325-944-8900
Practice Address - Fax:325-947-0101
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX540262171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator