Provider Demographics
NPI:1306984133
Name:FRAZIN, RACHEL M (CNP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:M
Last Name:FRAZIN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1841 DAYTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-6013
Mailing Address - Country:US
Mailing Address - Phone:651-644-4540
Mailing Address - Fax:
Practice Address - Street 1:1841 DAYTON AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-6013
Practice Address - Country:US
Practice Address - Phone:651-644-4540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR088249-3363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN043342000Medicaid
MN043342000Medicaid
MNS93078Medicare UPIN
500002796Medicare UPIN