Fraiser, Jacqueline A
Fraiser, Jacqueline A is an individual health care provider with primary practice located at 2601 Getwell Rd Ste 1 , Corinth MS 38834-6762. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Fraiser, Jacqueline A can be contacted via phone (662) 287-7138.Contact Information
Primary practice address
2601 Getwell Rd Ste 1
Corinth MS 38834-6762
Phone: (662) 287-7138
Fax: (662) 287-7157
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R851578 | Mississippi |
Profile Details
| NPI number | 1629199633 |
|---|---|
| LBN Legal business name | Fraiser, Jacqueline A |
| Credentials | CRNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 3rd, 2007 |
| Last updated | Jul 8th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629199633 | NPPES |
| Mississippi | MEDICAID | 02488503 |
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