Provider Demographics
NPI:1427597244
Name:FRALICKER, AARON (APRN - AUTONOMOUS)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:FRALICKER
Suffix:
Gender:M
Credentials:APRN - AUTONOMOUS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3880 COLONIAL BLVD STE 1A
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33966-1062
Mailing Address - Country:US
Mailing Address - Phone:239-936-1233
Mailing Address - Fax:239-936-8576
Practice Address - Street 1:3880 COLONIAL BLVD STE 1A
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-1062
Practice Address - Country:US
Practice Address - Phone:239-936-1233
Practice Address - Fax:855-552-3776
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-13
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9330103163W00000X
FLAPRN9330103363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse