Provider Demographics
NPI:1346585767
Name:FRYMAN, TRACY S (RN)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:S
Last Name:FRYMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 E PIKE ST
Mailing Address - Street 2:
Mailing Address - City:CYNTHIANA
Mailing Address - State:KY
Mailing Address - Zip Code:41031-1681
Mailing Address - Country:US
Mailing Address - Phone:859-569-3145
Mailing Address - Fax:
Practice Address - Street 1:209 E PIKE ST
Practice Address - Street 2:
Practice Address - City:CYNTHIANA
Practice Address - State:KY
Practice Address - Zip Code:41031-1681
Practice Address - Country:US
Practice Address - Phone:859-569-3145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-11
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1124537163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse