Individual
KIMBERLY CHRISTINE FRYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
171 KEMPSVILLE RD, #201, NORFOLK, VA 23502-4700
(757) 668-6550
(757) 893-6024
Mailing address
CHILDRENS SURGICAL SPECIALTY GROUP INC, PO BOX 631617, BALTIMORE, MD 21263-1617
(757) 668-6550
(757) 893-6024
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110001262
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006406971
—
VA
01
—
35573P
OPTIMA/SENTARA HEALTH
VA
Enumeration date
07/29/2006
Last updated
04/28/2009
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