Provider Demographics
NPI:1255821526
Name:DR. NANCY FRY, LLC
Entity type:Organization
Organization Name:DR. NANCY FRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:M
Authorized Official - Last Name:FRY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:913-226-8171
Mailing Address - Street 1:5302 W 99TH TER
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66207-3110
Mailing Address - Country:US
Mailing Address - Phone:913-226-8171
Mailing Address - Fax:
Practice Address - Street 1:1201 WAKARUSA DR # E103
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-4722
Practice Address - Country:US
Practice Address - Phone:913-226-8171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-12
Last Update Date:2018-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1967103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty