Individual
SHATINA FRAZIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20000 PIERSON ST, DETROIT, MI 48219-1310
(248) 818-4326
Mailing address
29600 FRANKLIN RD., #18, SOUTHFIELD, MI 48034
(248) 923-1234
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703113652
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2488184326
—
MI
Enumeration date
06/16/2017
Last updated
07/21/2022
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