Deborah A Frazer, ARNP

Individual provider Active NPI Family Nurse Practitioner · Bunnell, FL

NPI 1164498101 · NPPES record last updated Jan 18, 2023

Key facts

NPI
1164498101
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
1828882 (FL)
Practice address
301 Dr Carter Blvd
Bunnell, FL 32110-6212
Phone
(386) 437-7350
NPI assigned
Feb 28, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1828882FLMDObstetrics & Gynecology Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 1828882 FL
Family Nurse Practitioner 363LF0000X 1828882 FL Yes

Addresses

Primary practice location

301 Dr Carter Blvd
Bunnell, FL 32110-6212

Mailing address

301 Dr Carter Blvd
Bunnell, FL 32110-6212
Phone (386) 437-7350

Other identifiers

IdentifierTypeStateIssuer
302251000MedicaidFL

Other providers in Bunnell, FL

All providers in Bunnell, FL · Family Nurse Practitioner in Florida

Sources for this page

Verify at the official NPI Registry.