MEDICARE: FRYE NP, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner

General Provider Information

NPI Number	:	1316835085
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRYE NP, PLLC

Provider Business Mailing Address
First Line	:	6868 SKY POINTE DR UNIT 2010
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-6112
Country	:	US
Telephone Number	:	806-407-2117
Fax Number	:

Provider Business Practice Location Address
First Line	:	6868 SKY POINTE DR UNIT 2010
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-6112
Country	:	US
Telephone Number	:	806-407-2117
Fax Number	:

Authorized Official
Title or Position	:	OWNER / CEO
Name	:	TRACY FRYE
Credential	:	APRN
Telephone Number	:	806-407-2117

Provider Enumeration Date	:	06/24/2025
Last Update Date	:	12/02/2025

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