Healthcare Provider Details

I. General information

NPI: 1396755781
Provider Name (Legal Business Name): ELIZABETH ANN FRYMAN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 04/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21412 GREAT MILLS RD
LEXINGTON PK MD
20653-1203
US

IV. Provider business mailing address

20 NEW PLANT CT SUITE 204
OWINGS MILLS MD
21117-3525
US

V. Phone/Fax

Practice location:
  • Phone: 301-862-4501
  • Fax: 301-475-3085
Mailing address:
  • Phone: 410-655-8602
  • Fax: 410-654-8709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR073338
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: