Provider Demographics
NPI:1821316407
Name:EMPLEO-FRAZIER, OPHELIA SISON (MSN, GNP-BC)
Entity Type:Individual
Prefix:
First Name:OPHELIA
Middle Name:SISON
Last Name:EMPLEO-FRAZIER
Suffix:
Gender:F
Credentials:MSN, GNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 SCENIC CT
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-1859
Mailing Address - Country:US
Mailing Address - Phone:203-272-2171
Mailing Address - Fax:203-272-2171
Practice Address - Street 1:175 SCENIC CT
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-1859
Practice Address - Country:US
Practice Address - Phone:203-272-2171
Practice Address - Fax:203-272-2171
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002304363LF0000X
CT2304363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology