Provider Demographics
NPI:1508861048
Name:FRAZIER, DEANNA LYNN (AUD)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:LYNN
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1036 AMBERLEY WAY STE A
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8979
Mailing Address - Country:US
Mailing Address - Phone:859-972-9786
Mailing Address - Fax:859-972-9794
Practice Address - Street 1:1036 AMBERLEY WAY STE A
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-8979
Practice Address - Country:US
Practice Address - Phone:859-972-9786
Practice Address - Fax:859-972-9794
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY235500000X
231H00000X, 235500000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1517926OtherUMWA
KY45-0004OtherUNITED HEALTHCARE
KY000000041650OtherBLUE CROSS BLUE SHIELD
KY311503268OtherHUMANA
KY88193OtherCHA
KY6541026OtherCIGNA
KY70006507Medicaid
KY88193OtherCHA
KY70006507Medicaid