Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | ARNP9172177 | FL |
NPI | 1144516105 |
---|---|
Provider Name | Mrs. Kimberly Ann Frasier |
First Address | Pace, FL 32571-6201 |
Second Address | Pensacola, FL 32504-8721 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2011 |
Last Update Date | 27/09/2011 |