Individual
MRS. SUSAN MARIE FRAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
114 DOWNEY PL, CUBA, MO 65453-1640
(573) 885-3358
Mailing address
1533 S BROWNLEE BLVD, STE 100, CORPUS CHRISTI, TX 78404-3131
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2013017936
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366885667
—
MO
Enumeration date
04/17/2013
Last updated
02/22/2018
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