Individual
MRS. MACKENZIE GRACE FRIES
Active
Individual
MRS. MACKENZIE GRACE FRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
95036465
CA
363LA2100X
Acute Care Nurse Practitioner
95036465
CA
Other
Enumeration date
08/06/2025
Last updated
08/06/2025
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