| NPI | 1558703488 |
|---|---|
| Other Name | BETHENY LYN FRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171002) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001222593) |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2018-02-12 |