Provider Demographics
NPI:1437493285
Name:FRASIER, HAZEL DEAN (PMHNP)
Entity type:Individual
Prefix:
First Name:HAZEL
Middle Name:DEAN
Last Name:FRASIER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9995 GATE PKWY N STE 100
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-0800
Mailing Address - Country:US
Mailing Address - Phone:833-769-3524
Mailing Address - Fax:706-410-1490
Practice Address - Street 1:9995 GATE PKWY N STE 100
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-0800
Practice Address - Country:US
Practice Address - Phone:833-769-3524
Practice Address - Fax:706-410-1490
Is Sole Proprietor?:No
Enumeration Date:2012-11-17
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176919363LP0808X
FLARNP9170160363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health