Healthcare Provider Details

I. General information

NPI: 1003345471
Provider Name (Legal Business Name): NATALIE FRYE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2017
Last Update Date: 01/21/2021
Certification Date: 01/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 MAIN ST
SABETHA KS
66534-1832
US

IV. Provider business mailing address

1115 MAIN ST
SABETHA KS
66534-1832
US

V. Phone/Fax

Practice location:
  • Phone: 785-284-2141
  • Fax:
Mailing address:
  • Phone: 785-284-2141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number94-09265
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number04-43379
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: