Provider Demographics
NPI:1952025207
Name:FRAZEE, HANNAH NICOLE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:NICOLE
Last Name:FRAZEE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:NICOLE
Other - Last Name:NESSELRODT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1300 FORT PIERPONT DR SUITE # 101
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-1381
Mailing Address - Country:US
Mailing Address - Phone:304-241-7150
Mailing Address - Fax:304-599-8719
Practice Address - Street 1:1300 FORT PIERPONT DR SUITE # 101
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-1381
Practice Address - Country:US
Practice Address - Phone:304-241-7150
Practice Address - Fax:304-599-8719
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-30
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2740363AM0700X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical