Individual
MRS. SUZANNE MATLOCK FRYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2551 GREENWOOD ROAD, SUITE #410, SHREVEPORT, LA 71103
(318) 621-2929
(318) 621-2930
Mailing address
1202 LOUISIANA AVE, SHREVEPORT, LA 71101-3910
(318) 212-8951
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP07374
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP07374
LSBN
LA
Enumeration date
07/08/2013
Last updated
07/13/2021
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