Healthcare Provider Details

I. General information

NPI: 1083030860
Provider Name (Legal Business Name): AARON N. FRYE APRN, FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2014
Last Update Date: 03/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 QUEENDALE CTR
BEVERLY KY
40913-9608
US

IV. Provider business mailing address

53 QUEENDALE CTR
BEVERLY KY
40913-9608
US

V. Phone/Fax

Practice location:
  • Phone: 606-598-5135
  • Fax:
Mailing address:
  • Phone: 606-598-5135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3008584
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: