Provider Demographics
NPI:1710270632
Name:FRYE, GAIL LAURA (LPN)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:LAURA
Last Name:FRYE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16150 COUNTY HIGHWAY 23
Mailing Address - Street 2:
Mailing Address - City:UNADILLA
Mailing Address - State:NY
Mailing Address - Zip Code:13849-2407
Mailing Address - Country:US
Mailing Address - Phone:607-563-8146
Mailing Address - Fax:
Practice Address - Street 1:16150 COUNTY HIGHWAY 23
Practice Address - Street 2:
Practice Address - City:UNADILLA
Practice Address - State:NY
Practice Address - Zip Code:13849-2407
Practice Address - Country:US
Practice Address - Phone:607-563-8146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY274906164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse