Provider Demographics
NPI:1740050889
Name:FRAZIER, KATHANIA (APRN)
Entity type:Individual
Prefix:
First Name:KATHANIA
Middle Name:
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3215 BREEZE BLUFF WAY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-2287
Mailing Address - Country:US
Mailing Address - Phone:754-234-4259
Mailing Address - Fax:
Practice Address - Street 1:3215 BREEZE BLUFF WAY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-2287
Practice Address - Country:US
Practice Address - Phone:754-234-4259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1117754363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily