Individual
CHARCIE BRAY.FRAZIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
26620 BURG RD # C219, WARREN, MI 48089-1000
(313) 815-5091
Mailing address
26620 BURG RD # C219, WARREN, MI 48089-1000
(313) 815-5091
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703065092
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4703065092
LPN CERTIFICATIONS
MI
Enumeration date
02/02/2022
Last updated
02/02/2022
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