Provider Demographics
NPI:1891118337
Name:FRYE, PETER (CRNA)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:FRYE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:286 LEXINGTON DR
Mailing Address - Street 2:
Mailing Address - City:FLEETWOOD
Mailing Address - State:NC
Mailing Address - Zip Code:28626-9819
Mailing Address - Country:US
Mailing Address - Phone:978-771-2865
Mailing Address - Fax:
Practice Address - Street 1:286 LEXINGTON DR
Practice Address - Street 2:
Practice Address - City:FLEETWOOD
Practice Address - State:NC
Practice Address - Zip Code:28626-9819
Practice Address - Country:US
Practice Address - Phone:978-771-2865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-03
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC327398367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered