Provider Demographics
NPI:1417020900
Name:FRYMAN, JENNIFER L (FNPC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:L
Last Name:FRYMAN
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 PRAIRIE AVE
Mailing Address - Street 2:STE 1
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-4867
Mailing Address - Country:US
Mailing Address - Phone:307-632-0728
Mailing Address - Fax:307-632-5268
Practice Address - Street 1:1331 PRAIRIE AVE
Practice Address - Street 2:STE 1
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-4867
Practice Address - Country:US
Practice Address - Phone:307-632-0728
Practice Address - Fax:307-632-5268
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY19840.0839363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY124193100Medicaid
DN1175OtherRAILROAD MEDICARE - PALMETTO GBA
WY124193100Medicaid