Provider Demographics
NPI:1649759093
Name:FRAZIER, KRISTIANN (LPN)
Entity Type:Individual
Prefix:
First Name:KRISTIANN
Middle Name:
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4158 GREENFISH CT APT A
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98315-9510
Mailing Address - Country:US
Mailing Address - Phone:405-326-1400
Mailing Address - Fax:
Practice Address - Street 1:4158 GREENFISH CT APT A
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98315-9510
Practice Address - Country:US
Practice Address - Phone:405-326-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP60726669164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse