Provider Demographics
NPI:1588912570
Name:FRASER-GUGEL, BARBARA (LPN)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:FRASER-GUGEL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:
Other - Last Name:FRASER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:467 CHURCHILL DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14616-2115
Mailing Address - Country:US
Mailing Address - Phone:585-581-1239
Mailing Address - Fax:
Practice Address - Street 1:467 CHURCHILL DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14616-2115
Practice Address - Country:US
Practice Address - Phone:585-581-1239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-22
Last Update Date:2012-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY131740-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse