Provider Demographics
NPI:1164904561
Name:FROST, FELICITY (BS)
Entity Type:Individual
Prefix:
First Name:FELICITY
Middle Name:
Last Name:FROST
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 DAUGHTREY AVE APT 1223
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76706-1681
Mailing Address - Country:US
Mailing Address - Phone:760-799-2607
Mailing Address - Fax:
Practice Address - Street 1:66 DAUGHTREY AVE APT 1223
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76706-1681
Practice Address - Country:US
Practice Address - Phone:760-799-2607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other