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Individual

MS. JODY A. FRAZIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
2202 HARLEM RD STE 200, LOVES PARK, IL 61111-2754
(815) 877-4848
(815) 636-6125
Mailing address
2202 HARLEM RD STE 200, LOVES PARK, IL 61111-2754
(815) 877-4848
(815) 636-6125

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041380384
IL
163W00000X
Registered Nurse
76911-30
WI
367500000X
Certified Registered Nurse Anesthetist
209-007826
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209007826
IL
367500000X
Certified Registered Nurse Anesthetist
76911
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
43358900
WI
Enumeration date
08/12/2006
Last updated
07/21/2022
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