Provider Demographics
NPI:1366106486
Name:FRICKE, ELIZABETH LEIGH (ARNP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:LEIGH
Last Name:FRICKE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 E LONGPORT CIR # 6F1
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-3424
Mailing Address - Country:US
Mailing Address - Phone:561-702-4191
Mailing Address - Fax:
Practice Address - Street 1:1020 E LONGPORT CIR # 6F1
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33444-3424
Practice Address - Country:US
Practice Address - Phone:561-702-4191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11014570363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily