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Individual

ATHENIA FRAZIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3238 W NEW HAVEN AVE, MELBOURNE, FL 32904-3536
(321) 729-6747
Mailing address
1407 WIGMORE ST SE, PALM BAY, FL 32909-5756
(321) 339-9904

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5198342
FL

Other

Enumeration date
10/13/2015
Last updated
10/13/2015
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