Jennifer Diane Fraiser, COF
Individual provider Active NPI Orthotic Fitter · Anchorage, AK
NPI 1760158141 · NPPES record last updated Aug 17, 2021
Key facts
- NPI
- 1760158141
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthotic Fitter 225000000X
- License
- C53160 (AK)
- Practice address
- 3500 Latouche St Ste 380
Anchorage, AK 99508-4261 - Phone
- (907) 302-7367
- NPI assigned
- Aug 17, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C53160 | AK | MD | Orthotic Fitter |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Zia Medical Alaska, LLC | Current | Accepting new patients |
Locations
3500 Latouche St
Ste 380
Anchorage, AK 99508
Phone (907) 302-7367
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotic Fitter | 225000000X | C53160 | AK | Yes |
Addresses
Primary practice location
3500 Latouche St Ste 380
Anchorage, AK 99508-4261
Mailing address
3500 Latouche St Ste 380
Anchorage, AK 99508-4261
Phone (907) 302-7367
Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.