Provider Demographics
NPI:1730307067
Name:FRASHURE, KRISTY (RN)
Entity Type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:
Last Name:FRASHURE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 DALE RD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-2846
Mailing Address - Country:US
Mailing Address - Phone:410-255-2323
Mailing Address - Fax:410-222-6498
Practice Address - Street 1:164 DALE RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-2846
Practice Address - Country:US
Practice Address - Phone:410-255-2323
Practice Address - Fax:410-222-6498
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR149187163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse