Provider Demographics
NPI:1154572394
Name:FRAZIER, ROSINA (RN)
Entity type:Individual
Prefix:
First Name:ROSINA
Middle Name:
Last Name:FRAZIER
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 1:16601 KILBOURNE AVE
Mailing Address - Street 2:
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452-4621
Mailing Address - Country:US
Mailing Address - Phone:708-333-8653
Mailing Address - Fax:708-333-8659
Practice Address - Street 1:16601 KILBOURNE AVE
Practice Address - Street 2:
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-4621
Practice Address - Country:US
Practice Address - Phone:708-333-8653
Practice Address - Fax:708-333-8659
Is Sole Proprietor?:No
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041249978364SM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical