Provider Demographics
NPI:1235523879
Name:FRAZIER, AMANDA JO (APRN)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:JO
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-586-8200
Mailing Address - Fax:859-586-8233
Practice Address - Street 1:6105 1ST FINANCIAL DR
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:KY
Practice Address - Zip Code:41005-7892
Practice Address - Country:US
Practice Address - Phone:859-586-8200
Practice Address - Fax:859-586-8233
Is Sole Proprietor?:No
Enumeration Date:2015-03-20
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY3009022363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner