Provider Demographics
NPI:1740523570
Name:FRAZEE, PRISCILLA P (RN, ACNPC-AG, FNP-BC)
Entity type:Individual
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First Name:PRISCILLA
Middle Name:P
Last Name:FRAZEE
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Gender:F
Credentials:RN, ACNPC-AG, FNP-BC
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Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-8702
Mailing Address - Country:US
Mailing Address - Phone:970-624-4443
Mailing Address - Fax:970-490-4175
Practice Address - Street 1:1400 E BOULDER ST
Practice Address - Street 2:ATTN: HOSPITAL MEDICINE
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5533
Practice Address - Country:US
Practice Address - Phone:719-365-6044
Practice Address - Fax:719-365-6997
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-29
Last Update Date:2015-02-17
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Provider Licenses
StateLicense IDTaxonomies
CONP 0990682363LA2100X
CO0990682-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO62380869Medicaid
CO62380869Medicaid