Provider Demographics
NPI:1669189379
Name:FRAZIER, JAMES D (FNP-BC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:FRAZIER
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:JD
Other - Middle Name:
Other - Last Name:FRAZIER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:1138 S 4290 W
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:UT
Mailing Address - Zip Code:84015-6007
Mailing Address - Country:US
Mailing Address - Phone:801-628-6677
Mailing Address - Fax:
Practice Address - Street 1:2121 N 1700 W
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-8803
Practice Address - Country:US
Practice Address - Phone:801-773-4840
Practice Address - Fax:801-747-1023
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-02
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT355299-3102163W00000X
UT355299-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse