Provider Demographics
NPI:1831495688
Name:FRASER, JOSEPHINE OKOTETE (RN)
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:OKOTETE
Last Name:FRASER
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 1:2834 ALBEMARLE DR
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-5043
Mailing Address - Country:US
Mailing Address - Phone:614-986-7228
Mailing Address - Fax:
Practice Address - Street 1:2834 ALBEMARLE DR
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-5043
Practice Address - Country:US
Practice Address - Phone:614-986-7228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH364001163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse