Provider Demographics
NPI:1477135341
Name:FRAZIER, UKEISHA RENEE (NP)
Entity Type:Individual
Prefix:
First Name:UKEISHA
Middle Name:RENEE
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 1:1064 GARDNER RD STE 302
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-5746
Mailing Address - Country:US
Mailing Address - Phone:854-444-2838
Mailing Address - Fax:854-444-2839
Practice Address - Street 1:1064 GARDNER RD STE 302
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-5746
Practice Address - Country:US
Practice Address - Phone:854-444-2838
Practice Address - Fax:854-444-2839
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-21
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPRN.24901163W00000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163W00000XNursing Service ProvidersRegistered Nurse