Provider Demographics
NPI:1932533833
Name:SMITH-FRIES, CONNIE M
Entity Type:Individual
Prefix:MRS
First Name:CONNIE
Middle Name:M
Last Name:SMITH-FRIES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4908 MARYHILL RD
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-2622
Mailing Address - Country:US
Mailing Address - Phone:419-450-6590
Mailing Address - Fax:
Practice Address - Street 1:4908 MARYHILL RD
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2622
Practice Address - Country:US
Practice Address - Phone:419-450-6590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula