Provider Demographics
NPI:1376523381
Name:FRAZIER, DEBBY R (NP)
Entity Type:Individual
Prefix:MRS
First Name:DEBBY
Middle Name:R
Last Name:FRAZIER
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 1:1076 E CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-5843
Mailing Address - Country:US
Mailing Address - Phone:856-692-7979
Mailing Address - Fax:
Practice Address - Street 1:1076 E CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-5843
Practice Address - Country:US
Practice Address - Phone:856-692-7979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN08083200363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0079189Medicaid
NJQ15050Medicare UPIN
NJ078701CSBMedicare PIN