Individual ProviderJulie FrazeNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address6326 Constitution Dr, Fort Wayne, IN 46804-1518(260) 515-3275(260) 417-3352PECOS EnrollmentBased on the most recent information from CMS, provider Julie Fraze is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1740754050Provider TypeIndividualFull NameFraze, JulieGenderFemaleSole ProprietorNoEnumeration Date1/20/2019Last Updated1/20/2019Contact InformationPractice LocationPractice Address6326 Constitution Dr, Fort Wayne, IN 46804-1518Phone(260) 515-3275FaxUnlisted FaxMailing LocationMailing Address305 E 800 N, Uniondale, IN 46791-9747Phone(260) 417-3352FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense28119297AIndiana