Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | AP7202 | AZ |
NPI | 1023211513 |
---|---|
Provider Name | Mary C Frazee |
First Address | Scottsdale, AZ 85251-6900 |
Second Address | Scottsdale, AZ 85251-6900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2007 |
Last Update Date | 19/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
453861 | (05) | AZ |