Provider Demographics
NPI:1003703687
Name:FRIES, LYNETTE
Entity type:Individual
Prefix:
First Name:LYNETTE
Middle Name:
Last Name:FRIES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 S 46TH RD
Mailing Address - Street 2:
Mailing Address - City:DUNBAR
Mailing Address - State:NE
Mailing Address - Zip Code:68346-8825
Mailing Address - Country:US
Mailing Address - Phone:402-310-3539
Mailing Address - Fax:
Practice Address - Street 1:2010 N 19TH ST
Practice Address - Street 2:
Practice Address - City:NEBRASKA CITY
Practice Address - State:NE
Practice Address - Zip Code:68410-9665
Practice Address - Country:US
Practice Address - Phone:402-297-4993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion