Provider Demographics
NPI:1699832170
Name:FRALEY, EVELYN MARIE (ARNP)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:MARIE
Last Name:FRALEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 247
Mailing Address - Street 2:
Mailing Address - City:MC DOWELL
Mailing Address - State:KY
Mailing Address - Zip Code:41647-0247
Mailing Address - Country:US
Mailing Address - Phone:606-377-3400
Mailing Address - Fax:
Practice Address - Street 1:RT 122
Practice Address - Street 2:
Practice Address - City:MC DOWELL
Practice Address - State:KY
Practice Address - Zip Code:41647-0247
Practice Address - Country:US
Practice Address - Phone:606-377-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4929P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner