Provider Demographics
NPI:1801855093
Name:FRAZIER, LYNN D (AUD,CCC-A)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:D
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:AUD,CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 ORCHARD HILLS DR
Mailing Address - Street 2:APT. 224
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-8270
Mailing Address - Country:US
Mailing Address - Phone:812-449-8702
Mailing Address - Fax:
Practice Address - Street 1:111 ORCHARD HILLS DR
Practice Address - Street 2:APT. 224
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-8270
Practice Address - Country:US
Practice Address - Phone:812-449-8702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23001755231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200267510Medicaid
IN200267510Medicaid
INPO2262Medicare UPIN