Provider Demographics
NPI:1013583657
Name:FRAUSTO, EILEEN FRANCES (NP)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:FRANCES
Last Name:FRAUSTO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9913 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66220-3738
Mailing Address - Country:US
Mailing Address - Phone:913-634-0110
Mailing Address - Fax:
Practice Address - Street 1:9913 SUNSET DR
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66220-3738
Practice Address - Country:US
Practice Address - Phone:913-308-5498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95014934363LW0102X
KS5380781122363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health