Provider Demographics
NPI:1841826336
Name:FRAZIER, CHRISTINE (MS)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 ST CLAIR CIR
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:MI
Mailing Address - Zip Code:49230-8358
Mailing Address - Country:US
Mailing Address - Phone:517-937-1511
Mailing Address - Fax:
Practice Address - Street 1:144 ST CLAIR CIR
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:MI
Practice Address - Zip Code:49230-8358
Practice Address - Country:US
Practice Address - Phone:517-937-1511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-17
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist