Doctor Name: | STACY L FRAZER |
NPI Number: | 1659651479 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA |
License Number: | 21759 |
Business Practice Address: | 225 Spruce St Gridley, CA - 959482215 |
Business Phone Number: | 5308465655 |
Business Fax Number: | 5308463784 |
Mailing Address: | 225 Spruce St, GRIDLEY |
State: | CA |
Postal Code: | 959482215 |
Phone Number: | 5308465655 |
Fax Number: | 5308463784 |
NPI Enumeration Date: | 08/24/2011 |
NPI Last Update Date: | 08/24/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 21759 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |