Provider Demographics
NPI:1396755781
Name:FRYMAN, ELIZABETH ANN (CRNP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:FRYMAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 NEW PLANT CT
Mailing Address - Street 2:SUITE 204
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3525
Mailing Address - Country:US
Mailing Address - Phone:410-655-8602
Mailing Address - Fax:410-654-8709
Practice Address - Street 1:21412 GREAT MILLS RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON PK
Practice Address - State:MD
Practice Address - Zip Code:20653-1203
Practice Address - Country:US
Practice Address - Phone:301-862-4501
Practice Address - Fax:301-475-3085
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR073338363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD820603100Medicaid
MD820603100Medicaid
MD974LB350Medicare ID - Type UnspecifiedNURSE PRACTITIONER