Individual
MISS TIFFANY FRAZIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5000 W CHAMBERS ST, MILWAUKEE, WI 53210-1650
(414) 447-2171
(414) 858-2230
Mailing address
10625 W NORTH AVE STE 102, MILWAUKEE, WI 53226-2315
(414) 877-5350
(414) 877-5360
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
1075102
WI
363AM0700X
Medical Physician Assistant
Primary
10751
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41942600
—
WI
Enumeration date
07/18/2007
Last updated
07/21/2022
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