Individual
STEPHANIE FRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, RD, LDN, CDCES
Contact information
Practice address
4417 AGUALINDA BLVD, CAPE CORAL, FL 33914-6211
(239) 469-0866
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9646
(239) 343-9681
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
ND12759
FL
133V00000X
Registered Dietitian
Primary
86343660
FL
163WD0400X
Diabetes Educator Registered Nurse
9563454
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125199100
—
FL
Enumeration date
07/27/2024
Last updated
04/14/2026
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