Individual
JOLEA FRYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
401 MATTHEW ST, MARIETTA, OH 45750-1635
(740) 374-1580
(740) 376-1940
Mailing address
PO BOX 449, MARIETTA, OH 45750-0449
(740) 374-1580
(740) 376-1940
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
COA.00295.NA
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000505202
ANTHEM
OH
05
—
0781739
—
OH
05
—
5710198000
—
WV
Enumeration date
06/15/2006
Last updated
10/30/2009
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