Provider Demographics
NPI:1376020347
Name:FRYE, RACHAEL MARGARET (FNP-C)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:MARGARET
Last Name:FRYE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 ROSSMERE DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-3086
Mailing Address - Country:US
Mailing Address - Phone:894-767-0398
Mailing Address - Fax:
Practice Address - Street 1:20209 SENTARA WAY
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:VA
Practice Address - Zip Code:23314-3573
Practice Address - Country:US
Practice Address - Phone:757-542-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-23
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001256909163WG0000X
VA0024176389363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice