Provider Demographics
NPI:1588838791
Name:FRAZER, JOY P (RN, ND, RM, LM)
Entity Type:Individual
Prefix:DR
First Name:JOY
Middle Name:P
Last Name:FRAZER
Suffix:
Gender:F
Credentials:RN, ND, RM, LM
Other - Prefix:DR
Other - First Name:JOY
Other - Middle Name:P
Other - Last Name:KANEVSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, ND, RM, LM
Mailing Address - Street 1:679 E 2ND AVE
Mailing Address - Street 2:SUITE 4/5
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-5563
Mailing Address - Country:US
Mailing Address - Phone:970-946-1345
Mailing Address - Fax:970-385-1474
Practice Address - Street 1:679 E 2ND AVE
Practice Address - Street 2:SUITE 4/5
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5563
Practice Address - Country:US
Practice Address - Phone:970-946-1345
Practice Address - Fax:970-385-1474
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-17
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00001516175F00000X
COMWR-95175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay
No175F00000XOther Service ProvidersNaturopath