Doctor Name: | NIKKIYA M FRASER |
NPI Number: | 1013132109 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 7916 W Jefferson Blvd Fort Wayne, IN - 468044140 |
Business Phone Number: | 2604322297 |
Business Fax Number: | 2604346420 |
Mailing Address: | 7916 W Jefferson Blvd, FORT WAYNE |
State: | IN |
Postal Code: | 468044140 |
Phone Number: | 2604346339 |
Fax Number: | 2604346389 |
NPI Enumeration Date: | 04/16/2007 |
NPI Last Update Date: | 03/12/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |