Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 04-43379 | KS |
N | 207Q00000X | Family Doctor | 94-09265 | KS |
NPI | 1003345471 |
---|---|
Provider Name | Natalie Frye |
First Address | Sabetha, KS 66534-1832 |
Second Address | Sabetha, KS 66534-1832 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2017 |
Last Update Date | 21/01/2021 |