Individual provider Active NPI

Leslea Eldridge Fraser, LPN

  • Licensed Practical Nurse
  • Stuart, FL
National Provider Identifier
1629195243
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN1186941 Issued in FL
Practice address
2001 SE Jackson St
Stuart, FL 34997-5861
Phone
(772) 283-3076
Fax
(772) 283-3076
NPI assigned
Mar 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN1186941 FL Primary

Addresses

Primary practice location

2001 SE Jackson St
Stuart, FL 34997-5861

Mailing address

2001 SE Jackson St
Stuart, FL 34997-5861
Phone (772) 283-3076

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PN1186941FLMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629195243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 SE JACKSON ST",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349975861",
            "telephone_number": "772-283-3076",
            "fax_number": "772-283-3076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 SE JACKSON ST",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349975861",
            "telephone_number": "772-283-3076",
            "fax_number": "772-283-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRASER",
        "first_name": "LESLEA",
        "middle_name": "ELDRIDGE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN1186941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.