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Individual

MRS. JESSICA KIOUS-FRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ANP

Contact information

Practice address
11200 GOVERNOR MANLY WAY STE 303A, RALEIGH, NC 27614-7375
(919) 570-7590
(919) 570-7636
Mailing address
11200 GOVERNOR MANLY WAY STE 303A, RALEIGH, NC 27614-7375
(919) 570-7590
(919) 570-7636

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
5008281
NC
364SA2200X
Adult Health Clinical Nurse Specialist
APN0000017662
TN

Other

Enumeration date
09/18/2013
Last updated
05/10/2018
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