Provider Demographics
NPI:1912341330
Name:BARTLETT-FRYE, LIANNE (RN)
Entity Type:Individual
Prefix:
First Name:LIANNE
Middle Name:
Last Name:BARTLETT-FRYE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 ASHEVILLE RD
Mailing Address - Street 2:APT 2
Mailing Address - City:HYDE PARK
Mailing Address - State:MA
Mailing Address - Zip Code:02136-1302
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:32 ASHEVILLE RD
Practice Address - Street 2:APT 2
Practice Address - City:HYDE PARK
Practice Address - State:MA
Practice Address - Zip Code:02136-1302
Practice Address - Country:US
Practice Address - Phone:413-358-3366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-29
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2285146163W00000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse