Individual
ELIZABETH R FRAZIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1135 BROADWAY ST, SOUTH FULTON, TN 38257-2835
(731) 479-2606
(731) 479-2610
Mailing address
1135 BROADWAY ST, SOUTH FULTON, TN 38257-2835
(731) 479-2606
(731) 479-2610
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2205P
KY
363L00000X
Nurse Practitioner
Primary
6339
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103I500412
MEDICARE B-TN
TN
05
—
1531866
—
TN
01
—
295172
BCBS
KY
01
—
4060375
BCBS TN
TN
05
—
78008224
—
KY
Enumeration date
07/28/2006
Last updated
02/01/2024
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