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General NPI Number Information
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NPI Number | 1164119483
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Entity Type | Individual
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Provider Name | TRACY FRYE REGISTERED NURSE
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Gender | Female
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Dates
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Enumeration Date | 04/18/2023
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 7975 W SAHARA AVE
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City | LAS VEGAS
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State | NV
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Zip | 89117-7942
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Country | US
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Telephone | 806-407-2117
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Fax |
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Provider Business Mailing Address
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Address Line | 6868 SKY POINTE DR UNIT 2010
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City | LAS VEGAS
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State | NV
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Zip | 89131-6112
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Country | US
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Telephone | 806-407-2117
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 846509
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License Number State | NV
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