Healthcare Provider Details

I. General information

NPI: 1316835085
Provider Name (Legal Business Name): FRYE NP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6868 SKY POINTE DR UNIT 2010
LAS VEGAS NV
89131-6112
US

IV. Provider business mailing address

6868 SKY POINTE DR UNIT 2010
LAS VEGAS NV
89131-6112
US

V. Phone/Fax

Practice location:
  • Phone: 806-407-2117
  • Fax:
Mailing address:
  • Phone: 806-407-2117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TRACY FRYE
Title or Position: OWNER / CEO
Credential: APRN
Phone: 806-407-2117