Provider Demographics
NPI:1811403629
Name:FRYE, BERLINE CLARIS (CNP)
Entity Type:Individual
Prefix:MRS
First Name:BERLINE
Middle Name:CLARIS
Last Name:FRYE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:MRS
Other - First Name:BERLINE
Other - Middle Name:C
Other - Last Name:FRYE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN CNP-BC
Mailing Address - Street 1:200 OCEANGATE STE 100
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-4317
Mailing Address - Country:US
Mailing Address - Phone:888-665-4621
Mailing Address - Fax:
Practice Address - Street 1:6161 OAK TREE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-2581
Practice Address - Country:US
Practice Address - Phone:800-642-4168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-17
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH022176363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology