Individual
FAITH FRASER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REV
Contact information
Practice address
5390 LOCH LOMOND RD, MEMPHIS, TN 38116-9049
(901) 321-5511
Mailing address
5390 LOCH LOMOND RD, MEMPHIS, TN 38116-9049
(901) 321-5511
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00145595
STATE CERTIFICATION
TN
01
—
206040
STATE CERTIFICATION
WI
Enumeration date
12/30/2013
Last updated
12/30/2013
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