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ALICIA D FRASURE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP, PMHNP

Contact information

Practice address
604 N ROAN ST STE 101, JOHNSON CITY, TN 37601-4651
(423) 900-3534
(423) 558-2525
Mailing address
1735 W STATE OF FRANKLIN RD STE 5, PB270, JOHNSON CITY, TN 37604
(423) 900-3534
(423) 558-2525

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0024171150
VA
363LF0000X
Family Nurse Practitioner
17018
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
17018
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0024171150
FNP
VA
05
1530700
TN
01
APN17018
TN LICENSE
TN
01
RN169173
TN LICENSE
TN
Enumeration date
11/19/2012
Last updated
05/12/2025
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