Provider Demographics
NPI:1356602999
Name:FRAZIER, CRYSTAL YVETTE (LPN)
Entity type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:YVETTE
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4866 S WASHINGTON RD APT 4
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48601-7207
Mailing Address - Country:US
Mailing Address - Phone:989-475-2777
Mailing Address - Fax:
Practice Address - Street 1:4866 S WASHINGTON RD APT 4
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48601-7207
Practice Address - Country:US
Practice Address - Phone:989-475-2777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703099461164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse