Provider Demographics
NPI:1871917161
Name:FRYER, THERESA JILL (ARNP)
Entity type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:JILL
Last Name:FRYER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9225 N 3RD ST
Mailing Address - Street 2:STE 102
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2455
Mailing Address - Country:US
Mailing Address - Phone:602-362-2983
Mailing Address - Fax:480-565-4552
Practice Address - Street 1:9423 E YUCCA ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6115
Practice Address - Country:US
Practice Address - Phone:832-326-5059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-07
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ235107363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily