Provider Demographics
NPI:1598905002
Name:FRYE, JOCELYN ELAINE
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:ELAINE
Last Name:FRYE
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 1:354 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:IN
Mailing Address - Zip Code:47460-1626
Mailing Address - Country:US
Mailing Address - Phone:812-652-1053
Mailing Address - Fax:
Practice Address - Street 1:354 W MARKET ST
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:IN
Practice Address - Zip Code:47460-1626
Practice Address - Country:US
Practice Address - Phone:812-652-1053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker