Provider Demographics
NPI:1366924466
Name:FRAZIER, GABRIELA (FNP)
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 765
Mailing Address - Street 2:
Mailing Address - City:CALERA
Mailing Address - State:OK
Mailing Address - Zip Code:74730-0765
Mailing Address - Country:US
Mailing Address - Phone:580-579-3153
Mailing Address - Fax:
Practice Address - Street 1:156 ROSS RD
Practice Address - Street 2:
Practice Address - City:CALERA
Practice Address - State:OK
Practice Address - Zip Code:74730-4611
Practice Address - Country:US
Practice Address - Phone:580-579-3153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK107084363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily