Provider Demographics
NPI:1710332457
Name:FRY, KERRIANNE (MS)
Entity Type:Individual
Prefix:
First Name:KERRIANNE
Middle Name:
Last Name:FRY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WESNER LANE SUITE 201
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-2480
Mailing Address - Country:US
Mailing Address - Phone:570-214-9483
Mailing Address - Fax:570-214-6125
Practice Address - Street 1:15 WESNER LANE SUITE 201
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-9800
Practice Address - Country:US
Practice Address - Phone:570-214-9483
Practice Address - Fax:570-214-6125
Is Sole Proprietor?:No
Enumeration Date:2016-05-02
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS