Provider Demographics
NPI:1508604950
Name:FRASER, JULIA ADELINE (RN)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:ADELINE
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 1:110 EILEEN ST
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH PORT
Mailing Address - State:MA
Mailing Address - Zip Code:02675-2009
Mailing Address - Country:US
Mailing Address - Phone:508-737-6864
Mailing Address - Fax:
Practice Address - Street 1:110 EILEEN ST
Practice Address - Street 2:
Practice Address - City:YARMOUTH PORT
Practice Address - State:MA
Practice Address - Zip Code:02675-2009
Practice Address - Country:US
Practice Address - Phone:508-737-6864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2387527163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant