Provider Demographics
NPI:1669255451
Name:FRASCA, KERRI LYN
Entity type:Individual
Prefix:
First Name:KERRI
Middle Name:LYN
Last Name:FRASCA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3504 S GLENROSE RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-1136
Mailing Address - Country:US
Mailing Address - Phone:619-990-5208
Mailing Address - Fax:
Practice Address - Street 1:3504 S GLENROSE RD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-1136
Practice Address - Country:US
Practice Address - Phone:619-990-5208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider