Provider Demographics
NPI:1760813950
Name:FRASER, ROBERT EUGENE (RN-BC, CIC, CLNC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:EUGENE
Last Name:FRASER
Suffix:
Gender:M
Credentials:RN-BC, CIC, CLNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 704
Mailing Address - Street 2:BOX 3429
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96338-0015
Mailing Address - Country:US
Mailing Address - Phone:315-263-3691
Mailing Address - Fax:315-263-4100
Practice Address - Street 1:US ARMY MEDICAL DEPARTMENT ACTIVITY-JAPAN
Practice Address - Street 2:UNIT 45011
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96343-5011
Practice Address - Country:US
Practice Address - Phone:315-263-4546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI57389163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health