Provider Demographics
NPI:1154781730
Name:FRIES, LAURA H (MSN, CNP, FNP-C)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:H
Last Name:FRIES
Suffix:
Gender:F
Credentials:MSN, CNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4565 DRESSLER RD NW
Mailing Address - Street 2:SUITE 111
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2549
Mailing Address - Country:US
Mailing Address - Phone:330-493-0013
Mailing Address - Fax:330-493-6973
Practice Address - Street 1:4565 DRESSLER RD NW
Practice Address - Street 2:SUITE 111
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2549
Practice Address - Country:US
Practice Address - Phone:330-493-0013
Practice Address - Fax:330-493-6973
Is Sole Proprietor?:No
Enumeration Date:2016-02-25
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.18624-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily