Provider Demographics
NPI:1265781462
Name:FRAZIER, CHANELLE LAJUAN (PCA)
Entity type:Individual
Prefix:
First Name:CHANELLE
Middle Name:LAJUAN
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:PCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 K STREET NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005
Mailing Address - Country:US
Mailing Address - Phone:202-293-2931
Mailing Address - Fax:202-293-3480
Practice Address - Street 1:1010 VERMONT AVE NW STE 1003
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-4927
Practice Address - Country:US
Practice Address - Phone:202-827-9004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-04
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No374U00000XNursing Service Related ProvidersHome Health Aide