Samuel Frazier, APRN, CNS
Clinical Nurse Specialist in Gresham, OR. Individual provider (NPI-1).
NPI number1194451971
StatusActive
Last updated in NPPESMay 8, 2025
Details
- NPI
- 1194451971
- Entity type
- Individual (NPI-1)
- Name
- Samuel Frazier
- Credential
- APRN, CNS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 25, 2022
- Certification date
- May 8, 2025
- Last updated
- May 8, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 364S00000X | Clinical Nurse Specialist | 10037912 | OR | Yes |
| 364S00000X | Clinical Nurse Specialist | 1087151 | TX |
Practice location
24900 Se Stark St Ste 109Gresham, OR 97030-3381
Phone 503-413-7162
Mailing address
2603 Carlow DrAustin, TX 78745-4346
Phone 512-507-6664
Other practice locations
2603 Carlow Dr
Austin, TX 78745-4346
Austin, TX 78745-4346
Phone 512-507-6664
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