Healthcare Provider Details

I. General information

NPI: 1912284837
Provider Name (Legal Business Name): APRIL JENNIFER FRYE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2011
Last Update Date: 10/20/2023
Certification Date: 10/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 DEFENSE PENTAGON
WASHINGTON DC
20310-8023
US

IV. Provider business mailing address

111 S GEORGE MASON DR
ARLINGTON VA
22204-1373
US

V. Phone/Fax

Practice location:
  • Phone: 703-692-8810
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA07807
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: