Individual provider Active NPI

Jennifer Lyn Frasier, RN

  • Registered Nurse
  • Pendleton, OR
National Provider Identifier
1912779471
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
089003115RN Issued in OR
Practice address
1323 SW 40TH St
Pendleton, OR 97801-4203
Phone
(503) 956-7128
NPI assigned
Oct 26, 2023
Last updated
Oct 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 089003115RN OR Primary

Addresses

Primary practice location

1323 SW 40TH St
Pendleton, OR 97801-4203

Mailing address

1323 SW 40TH St
Pendleton, OR 97801-4203
Phone (503) 956-7128

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
089003115RNORMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1698278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1912779471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1323 SW 40TH ST",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978014203",
            "telephone_number": "503-956-7128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1323 SW 40TH ST",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978014203",
            "telephone_number": "503-956-7128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRASIER",
        "first_name": "JENNIFER",
        "middle_name": "LYN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-26",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "089003115RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pendleton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.