Provider Demographics
NPI:1831886456
Name:FRAZEE, KRISTYN R (CPT)
Entity type:Individual
Prefix:MRS
First Name:KRISTYN
Middle Name:R
Last Name:FRAZEE
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 SE HILLSIDE DR APT B
Mailing Address - Street 2:
Mailing Address - City:OAK GROVE
Mailing Address - State:MO
Mailing Address - Zip Code:64075-9417
Mailing Address - Country:US
Mailing Address - Phone:816-493-9436
Mailing Address - Fax:
Practice Address - Street 1:1403 SE HILLSIDE DR APT B
Practice Address - Street 2:
Practice Address - City:OAK GROVE
Practice Address - State:MO
Practice Address - Zip Code:64075-9417
Practice Address - Country:US
Practice Address - Phone:816-493-9436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO46913-168-018-9101246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy