Individual
DANIELLE NICOLE FRIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP-BC
Contact information
Practice address
6812 STATE ROUTE 162 STE 200, MARYVILLE, IL 62062-8562
(618) 288-0900
(618) 288-0909
Mailing address
12855 N 40 DR STE 375, SAINT LOUIS, MO 63141-8657
(314) 567-6071
(618) 288-0909
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
2017007578
MO
363LA2200X
Adult Health Nurse Practitioner
Primary
209015785
IL
Other
Enumeration date
03/15/2017
Last updated
07/21/2022
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