Provider Demographics
NPI:1699288340
Name:FRAZIER, SHANNON TAMIKA (APN)
Entity type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:TAMIKA
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 20TH AVE N FL 789
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2131
Mailing Address - Country:US
Mailing Address - Phone:615-284-1400
Mailing Address - Fax:615-284-1420
Practice Address - Street 1:300 20TH AVE N FL 789
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2131
Practice Address - Country:US
Practice Address - Phone:615-284-1400
Practice Address - Fax:615-284-1420
Is Sole Proprietor?:No
Enumeration Date:2017-11-15
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN22544363LC1500X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health