MEDICARE: MELISSA R FRYE FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP4382	AZ
2	207Q00000X	Family Medicine Physician	AP4382	AZ

General Provider Information

NPI Number	:	1629342787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA R FRYE FNP

Provider Business Mailing Address
First Line	:	9819 N STONECREEK PL
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85742-9585
Country	:	US
Telephone Number	:	520-236-7336
Fax Number	:

Provider Business Practice Location Address
First Line	:	3820 N ORACLE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85705-3227
Country	:	US
Telephone Number	:	520-200-6707
Fax Number	:	520-300-8052

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2012
Last Update Date	:	03/17/2022

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