Healthcare Provider Details

I. General information

NPI: 1083039010
Provider Name (Legal Business Name): JENNIFER FRYE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2014
Last Update Date: 02/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2797 NC 55 HWY MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA, P.C.
CARY NC
27519-6206
US

IV. Provider business mailing address

7233 CALEY LN
DENVER NC
28037-0049
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax: 401-652-9787
Mailing address:
  • Phone: 828-446-1980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF0414093
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number195087
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: