Provider Demographics
NPI:1801902010
Name:FRAZER, HARLANE SUE (RPH)
Entity type:Individual
Prefix:MS
First Name:HARLANE
Middle Name:SUE
Last Name:FRAZER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3169 E BANK RD
Mailing Address - Street 2:
Mailing Address - City:LIME SPRINGS
Mailing Address - State:IA
Mailing Address - Zip Code:52155-8124
Mailing Address - Country:US
Mailing Address - Phone:563-419-8302
Mailing Address - Fax:
Practice Address - Street 1:303 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:CRESCO
Practice Address - State:IA
Practice Address - Zip Code:52136-1843
Practice Address - Country:US
Practice Address - Phone:563-547-5111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA15992183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist