MS. VICKIE BRADLEY FRASER APRN PMHNP-BC LPC NPI 1104165893

NPI Information

  • NPI: 1104165893
  • Provider Name: MS. VICKIE BRADLEY FRASER, APRN, PMHNP-BC, LPC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 6200 PFEIFFER RD
    MONTGOMERY, OH
    ZIP 45242
  • Phone: (513) 862-4957

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NPI Details

MS. Vickie Bradley Fraser, APRN, PMHNP-BC, LPC is a psychiatric/mental health nurse practitioner in Montgomery, OH with 4 years of experience. MS. Vickie Bradley Fraser, APRN, PMHNP-BC, LPC NPI is 1104165893. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

6200 PFEIFFER RD
MONTGOMERY, OH
ZIP 45242-862
Phone: (513) 862-4957

The NPI 1104165893 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/31/2013 and was last updated on 10/31/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163WC0200XRegistered NurseCritical Care MedicineRN.427558OHIONo
2163WC0200XRegistered NurseCritical Care Medicine1150760KENTUCKYNo
32084P0800XPsychiatry & NeurologyPsychiatry3017561KENTUCKYNo
42084P0800XPsychiatry & NeurologyPsychiatryAPRN.CNP.0031019OHIONo
5363LP0808XNurse PractitionerPsychiatric/Mental HealthAPRN.CNP.0031019OHIOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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