Provider Demographics
NPI:1518319128
Name:FRYE, SHARI (ARNP)
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:
Last Name:FRYE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 MEMORIAL CIR
Mailing Address - Street 2:SUITE C
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-5071
Mailing Address - Country:US
Mailing Address - Phone:386-615-3500
Mailing Address - Fax:386-615-3505
Practice Address - Street 1:500 MEMORIAL CIR
Practice Address - Street 2:SUITE C
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-5071
Practice Address - Country:US
Practice Address - Phone:386-615-3500
Practice Address - Fax:386-615-3505
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-07
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP1743202363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology