Provider Demographics
NPI:1053082115
Name:FRAZIER, KSHAWNDA (BSN, RN, MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:KSHAWNDA
Middle Name:
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:BSN, RN, MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2580 LAKE COMMONS CT
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-6449
Mailing Address - Country:US
Mailing Address - Phone:678-683-0128
Mailing Address - Fax:
Practice Address - Street 1:2580 LAKE COMMONS CT
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6449
Practice Address - Country:US
Practice Address - Phone:678-683-0128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health