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General NPI Number Information
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NPI Number | 1558174722
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Entity Type | Individual
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Provider Name | ELYSSA MORGAN FRY
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Gender | Female
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Dates
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Enumeration Date | 01/30/2025
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 600 N 2ND ST STE 401
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City | HARRISBURG
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State | PA
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Zip | 17101-1071
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Country | US
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Telephone | 415-403-2156
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Fax |
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Provider Business Mailing Address
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Address Line | 1268 TILGHMAN ST
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City | EMMAUS
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State | PA
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Zip | 18049-3530
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Country | US
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Telephone | 570-881-4135
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | SP032039
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License Number State | PA
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