Provider Demographics
NPI:1720589492
Name:FRAZIER, HOLLI LORAINNE (LVN)
Entity Type:Individual
Prefix:
First Name:HOLLI
Middle Name:LORAINNE
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:HOLLI
Other - Middle Name:LORAINNE
Other - Last Name:FRAZIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13560 E FM 321
Mailing Address - Street 2:
Mailing Address - City:PALESTINE
Mailing Address - State:TX
Mailing Address - Zip Code:75803-1129
Mailing Address - Country:US
Mailing Address - Phone:903-584-3121
Mailing Address - Fax:
Practice Address - Street 1:755 S BECKHAM AVE
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-1903
Practice Address - Country:US
Practice Address - Phone:903-534-4684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-27
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX228435164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse