Provider Demographics
NPI:1740887306
Name:FRAZEE, COLLEEN SUE
Entity type:Individual
Prefix:MS
First Name:COLLEEN
Middle Name:SUE
Last Name:FRAZEE
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 1:27445A NEWCASTLE RD
Mailing Address - Street 2:
Mailing Address - City:GAMBIER
Mailing Address - State:OH
Mailing Address - Zip Code:43022-9765
Mailing Address - Country:US
Mailing Address - Phone:740-427-3852
Mailing Address - Fax:
Practice Address - Street 1:27445A NEWCASTLE RD
Practice Address - Street 2:
Practice Address - City:GAMBIER
Practice Address - State:OH
Practice Address - Zip Code:43022-9765
Practice Address - Country:US
Practice Address - Phone:740-427-3852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH42044173747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant