Individual
JENA L FRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
712 SAINT JOHN ST, GARDEN CITY, KS 67846-5128
(620) 275-1766
Mailing address
712 SAINT JOHN ST, GARDEN CITY, KS 67846-5128
(620) 275-1766
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1500856
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100450410A
—
KS
Enumeration date
08/12/2006
Last updated
04/02/2024
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