Provider Demographics
NPI:1871224071
Name:FRASER, EMILY JO (APRN)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:JO
Last Name:FRASER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 NORTON DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-9173
Mailing Address - Country:US
Mailing Address - Phone:859-314-7290
Mailing Address - Fax:
Practice Address - Street 1:1700 NICHOLASVILLE RD STE 701
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1467
Practice Address - Country:US
Practice Address - Phone:859-278-0396
Practice Address - Fax:859-277-5414
Is Sole Proprietor?:No
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3017689363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily