Provider Demographics
NPI:1376191783
Name:FRYER, ERIEN WYNNE
Entity Type:Individual
Prefix:
First Name:ERIEN
Middle Name:WYNNE
Last Name:FRYER
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 1:190 HATCHER LN STE B
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-5989
Mailing Address - Country:US
Mailing Address - Phone:931-546-9747
Mailing Address - Fax:
Practice Address - Street 1:190 HATCHER LN STE B
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-5989
Practice Address - Country:US
Practice Address - Phone:931-546-9747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-28
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1326013566OtherVETERANS ADMINISTRATION