Provider Demographics
NPI:1932081734
Name:FRAZIER, BRIANA (CNA)
Entity type:Individual
Prefix:
First Name:BRIANA
Middle Name:
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:882 COUNTY ROAD 75
Mailing Address - Street 2:
Mailing Address - City:BLUE MOUNTAIN
Mailing Address - State:MS
Mailing Address - Zip Code:38610-9635
Mailing Address - Country:US
Mailing Address - Phone:631-690-9213
Mailing Address - Fax:
Practice Address - Street 1:882 COUNTY ROAD 75
Practice Address - Street 2:
Practice Address - City:BLUE MOUNTAIN
Practice Address - State:MS
Practice Address - Zip Code:38610-9635
Practice Address - Country:US
Practice Address - Phone:631-690-9213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS73541376K00000X
3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376K00000XNursing Service Related ProvidersNurse's Aide