Casandra Fay Fraser

Individual provider Active NPI Peer Specialist · Concho, OK

NPI 1396487997 · NPPES record last updated Mar 31, 2023

Key facts

NPI
1396487997
Entity type
Individual (NPI type 1)
Primary specialty
Peer Specialist 175T00000X
Practice address
100 Red Moon Circle
100 Red Moon Circle
Concho, OK 73022
Phone
(405) 422-7452
NPI assigned
Apr 13, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X Yes

Addresses

Primary practice location

100 Red Moon Circle
100 Red Moon Circle
Concho, OK 73022

Mailing address

1400 W Elm St Apt 251400
El Reno, OK 73036-4952
Phone (405) 549-3519

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address cfraser@cheyenneandarapaho-nsn.gov Other

Other providers in Concho, OK

All providers in Concho, OK · Peer Specialist in Oklahoma

Sources for this page

Verify at the official NPI Registry.