Provider Demographics
NPI:1649745951
Name:FRASSE, GIGI Y (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:GIGI
Middle Name:Y
Last Name:FRASSE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:GIGI
Other - Middle Name:
Other - Last Name:LIU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10000 SHANNONDELL DR
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-5615
Mailing Address - Country:US
Mailing Address - Phone:484-227-9770
Mailing Address - Fax:
Practice Address - Street 1:10000 SHANNONDELL DRIVE MAIN LINE HEALTHCARE
Practice Address - Street 2:
Practice Address - City:AUDOBON
Practice Address - State:PA
Practice Address - Zip Code:19403
Practice Address - Country:US
Practice Address - Phone:484-227-9770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-12
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP019172363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily